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GLIMPSES   OF 

MEDICAL  EUROPE 


Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


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GLIMPSES  OF 

MEDICAL  EUROPE 

BY 
RALPH  L.  THOMPSON,  M.D. 

Professor  of  Pathology, 
St.  Louis  University  School  of  Medicine 

ILLUSTRATED  FROM  rilOTOGUAVnS 
AND  FROM  DRAWINGS  BY 

TOM  JONES 

PHILADELPHIA  &  LONDON 
J.  B.  LIPPINCOTT   COMPANY 

1908 

Copyright,  1908 
By  J.  B.  LippiNCOTT  Company 


Putdished  April,  1908 


Electrotyped  and  printed  by  J.  B.  Lippincott  Company 
The  Washington  Square  Press,  Philadelphia,  V.  S.  A. 


TO 

K.  W.  M. 


INTRODUCTION. 

One  who  lays  no  claim  to  being  a  literary 
man  should  not  write  a  book  to  begin  with. 
And  of  all  subjects  that  might  be  chosen,  a 
book  on  Europe  is  the  one  that  most  requires 
an  apology.  However,  I  am  not  going  to 
apologize  for  the  present  volume,  because  I 
didn't  want  to  write  it,  anyway.  It  began  by 
my  sending  home  a  few  letters  to  an  editor 
who  wanted  to  fill  up  a  certain  amount  of 
space.  Once  started,  it  just  naturally  grew 
into  its  present  form. 

There  has  been  no  attempt  at  making  this 
book  a  guide-book  in  any  sense,  although 
things  of  importance  to  a  man  who  is  going 
to  study  medicine  abroad  have  crept  into  it 
despite  the  author.  It  does  not  intend  to 
describe  anything  accurately  (modern  art 
doesn't  allow  that),  but  it  tries  to  sketch  the 
things  medical  in  Europe  that  I  have 
happened  to  see,  as  they  appeared  to  me: 
comme  je  Vai  vu. 

All  books  should  have  a  purpose,  and  if 
this  book  didn't  have  one  I  wouldn't  have 
spent  my  evenings  writing  these  chapters 
instead  of  joining  my  friends  in  the  more  con- 


INTRODUCTION 

genial  occupation  of  holding  down  a  chair  in 
one  of  the  famous  cafes  on  Friedrichstrasse 
or  the  ''Boul'  Mich."  If  you  see  the  pur- 
pose, then  you  will  pack  your  steamer  trunk 
at  your  first  opportunity,  and  perhaps  we'll 
touch  elbows  in  some  of  the  places  to  which 
these  pages  may  attract  you. 

The  author  is  indebted  to  the  St.  Louis 
Medical  Review  for  permission  to  reprint 
such  of  these  chapters  as  first  appeared  in 
that  publication ;  and  to  the  Anglo-American 
Medical  Association  of  Berlin  for  the  in- 
formation concerning  courses  offered  in 
Berlin  for  American  students. 

R.  L.  T. 


II. 
III. 

IV. 

V. 

VI. 

VII. 

VIII. 

IX. 
X. 

XI. 
XII. 

XIII. 

XIV. 

XV. 

XVI. 

I. 
II. 


Introductory  —  Christiansand  —  Christi- 

ania — holmenkollen 11 

Copenhagen — Municipal  Hospitals 22 

Copenhagen — The  Finsen  Institute 31 

Stockholm  —  Noteworthy  Medical  Insti- 
tutions   39 


48 
59 

74 

90 


Upsala — The  University  of  Sweden 

St.  Petersburg — Its  Numerous  Hospitals  . . 

Berlin — Anglo-American  Medical  Society 

Berlin — ^Charite  and  Pathological  Insti- 
tute  

Berlin — Hospitals  and  Clinics 103 

Berlin — Dr.  Pick — A  Pathological  Pil- 
grimage    115 

Vienna  and  Budapest 127 

Paris — St.  Louis  Hospital — Scenes  at  the 
Skin  Clinic 140 

Paris — The  Parisian  Life — The  Surgical 
Clinics 152 

Paris — The  Pasteur  Institute — Metchni- 
koff 165 

London  —  The  Hospitals  —  Sir  A.  E. 
Wright's  Laboratory 180 

Liverpool — The  University — The  School 
OF  Tropical  Medicine 190 

APPENDICES. 

A  List  of  Medical  Courses  for  Americans 

IN  Berlin 205 

German  Universities 222 

7 


LIS?  or  ILLVSTRATIONS 


The   First    Glimpse Frontispiece 

Sanatoria  Seen  From  the  Norwegian  Fjords...  15 

Oslo  Hospital — Christiania 17 

holmenkollen 19 

Friederik's  Hospital — Copenhagen 24 

Municipal  Hospital — Copenhagen 27 

Niels  Finsen 31 

The  Roy.\l  Palace — Stockholm 40 

The  Opera  House  "Cellar" — Stockholm 45 

Carl  von  Linnaeus 49 

House  of  Linnaeus 51 

Anatomical  Institute — Upsala 53 

University  Hospital — Upsala 55 

Russian  Droschke 60 

Pawlow 67 

Russian  Peasants 69 

Monument  to  Peter  the  Great 72 

The  Anglo-American  Medical  Society  of  Berlin  75 

Royal  Charite  Hospital 83 

Park  of  The  Charite 92 

Grounds  of  the  Charite 96 

Rudolph  Virchow 97 

9 


ILLUSTRATIONS 

Surgical  Clinic-Charite 100 

Nerve  Clinic — Charite 101 

Orth 104 

Grounds  of  Moabit  Hospital 106 

Philippstrasse — Berlin 116 

Dr.  Pick's  Laboratory 117 

LuDwiG  Pick 123 

A  Wiener  Type 128 

The  University — Vienna 129 

Allgemeines  Krankenhaus — Vienna 132 

Administration    Building    General    Hospital — 

Vienna 136 

Park  in  General  Hospital — Vienna 137 

The  Paris  Morgue 141 

A  Collector  of  Cigar  "Butts" 146 

Visite  a  l'Hopital  (Ll'xembourg) 156 

Hotel  Dieu,  From  Notre  Dame 161 

Pasteur  Institute 166 

Pasteur •  • ^^^ 

Chemistry  Institute — Paris 173 

Metchnikoff 177 

Bloomsbury  Square. 181 

The  Last  Glimpse 201 

University  of  Berlin 206 

Friedrick  Wilhelm  Hospital — Berlin 215 

Johannstadt  Infirmary — Dresden 225 

The  University— Munich 229 

The  University — Leipzig 231 


Glimpses  of 

Medical  Europe 
I. 

THE    CROSSING CHRISTIANSAND CHRISTI- 

ANIA HOLMENKOLLEX. 

Whatever  city  may  be  the  objective  point 
for  medical  study  abroad,  the  important  thing 
is  to  choose  the  most  indirect  route  for  reach- 
ing it.  Too  frequently  one  takes  a  steamer 
for  Hamburg  and  is  walking  a  hospital  in 
Berlin  before  one  has  lost  his  sea  legs.  The 
result  is  usually  a  rapid  decline  of  interest  in 
the  clinics,  and  a  desire  to  know  more  of  the 
life  of  the  cafes.  Especially  is  this  true  when, 
as  is  frequently  the  case,  one  is  just  over  the 
grind  of  the  final  examination  at  home,  or  is 
taking  a  few  months  off  from  a  busy  practice. 
Far  wiser  is  it  to  take  down  the  map  and, 
after  sticking  a  pin  in  Vienna,  or  Berlin,  or 
wherever  one  wishes  to  go,  to  plan  a  trip 
that  will  take  about  a  month  to  reach  the 
selected  city,  after  you  yourself  and  your 
several  pieces  of  luggage  have  been  landed 
on   European   soil. 

11 


MEDICAL  EUROPE 

If  you  are  an  old  and  experienced  traveller 
and  know  just  what  you  want  and  why  you 
want  it,  this  doesn't  apply,  and  you  should 
go  to  your  particular  place  as  quickly  as 
steam  and  rail  will  carry  you.  I  know  a  man, 
for  example,  who  considers  that  every  moment 
of  his  travelling  life  that  isn't  spent  in  Paris 
(and  a  certain  quarter  of  Paris  at  that)  is 
wasted,  and  who  rushes  from  his  last  class 
exercise  in  the  Spring  to  the  station,  catches 
the  first  steamer  sailing  for  Havre,  and  is 
driven  like  fury  from  the  dock  to  the  Paris 
Express.  Then  he  doesn't  wriggle  out  of  his 
particular  quarter  of  Paris  until  the  last 
possible  moment,  when  he  is  forced  to  re- 
verse the  previous  procedure  and  get  back  to 
his  class-room. 

The  first  trip  over,  however,  should  be 
undertaken  with  a  good  deal  of  care  and 
forethought.  The  easiest  thing  to  do  is  to 
take  one  of  the  big  direct  liners  that  will 
land  you  on  English,  French,  or  German 
soil,  as  you  prefer;  but  that,  as  I  said  in  the 
beginning,  is  to  be  avoided  if  possible.  It's 
too  easy.  Then  there  is  the  Liverpool  trip, 
which  used  to  be  a  favorite  on  account  of 
the  better  boats  once  on  that  service,  but 
which  now  has  lost  ground. 

The   Southern   route   is    always    a  favorite 

12 


THE  CROSSING 

avenue  of  approacli.  The  Mediterranean  Is 
usually  good-natured,  and  the  lazy  linger- 
ing at  Naples,  Rome,  Florence,  and  Venice 
has  its  charms.  Then,  if  you  are  going  to 
Vienna  there  is  the  ride  through  the  Eastern 
Alps,  which  is  one  of  the  most  beautiful  of 
railroad  trips.  Many  choose  this  route,  and 
they  are  wise.  But  if  you  have  taken  it  once 
and  wish  for  a  change,  you  will  be  none  the 
less  pleased  should  you  choose  the  approacli 
by  way  of  Norway,  Sweden,  and  Denmark. 
A  stanch  steamer  will  take  you  to  Christian- 
sand  in  ten  days.  The  next  day  you  are  at 
Christiania,  a  typical  Norwegian  city,  and,  if 
you  wish  it,  the  day  following  finds  you  in 
Copenhagen,  the  "Paris  of  the  North." 

Having  taken  both  of  these  latter  trips,  I 
should  recommend  that  you  choose  according 
as  you  prefer  salads  or  sandwiches.  If  salads 
be  preferred,  take  the  Southern  route  by  all 
means.  There  is  no  proper  place  to  eat  a 
salad,  except  in  sight  of  the  trees  that  furnish 
the  oil  for  the  dressing;  and  a  salad  in  Italy 
is  a  thing  to  live  for.  However,  if  you  care 
little  for  salads  but  do  like  real  food,  take  the 
Northern  route.  The  Scandinavian  food  is 
unexcelled,  and  the  acme  of  the  Scandinavian 
cuisine  is  the  sandwich.  At  home  a  sandwich 
is  a  sort  of  lottery  at  best.     It  looks  the  same 

13 


MEDICAL  EUROPE 

from  both  sides.  Whatever  may  be  within  is 
left  to  faith  to  discover.  But  the  Scandinavian 
sandwich  is  open-faced.  There  is  nothing 
about  it  that  is  ashamed.  First  is  the  deh- 
cately  sHced  piece  of  bread;  next  a  generous, 
smoothly  laid  layer  of  sweet  Danish  butter; 
and,  above  all,  your  thin,  appetizing  slice  of 
meat  or  fish  or  cheese  or  what  not.  When  I 
get  back  I  am  going  to  agitate  the  raising  of 
the  "lid"  from  the  American  sandwich. 

There  are  a  few  things  worthy  of  note 
regarding  the  hygiene  of  ocean  travel.  On 
the  whole,  the  health  of  the  passengers  is 
well  protected.  Quarantine  rules  have  gone 
a  great  way  towards  limiting  disease,  but 
there  is  still  room  for  improvement.  For 
instance,  a  steamship  would  be  held  up  in- 
stantly on  suspicion  of  cholera,  smallpox,  or 
yellow  fever,  but  apparently  no  attention  is 
paid  to  tuberculosis.  On  our  boat  there  were 
two  bad  cases  of  the  latter.  A  man  in  the 
second  cabin  sat  at  the  table  with  other  pas- 
sengers and  coughed  at  will  into  his  napkin. 
He  was  assigned  to  a  state-room  with  another 
passenger,  but  owing  to  the  strenuous  objec- 
tion of  his  room-mate  he  was  asked  to  sleep 
in  the  hospital.  A  girl  in  the  steerage,  how- 
ever, was  not  so  fortunate  in  disposing  of  her 
cabin  companion.     This  girl,  who  had  failed 

14 


CHRISTIAXSAXD 

to  pass  the  immigration  officers  in  New  York 
for  some  reason  and  had  to  be  taken  back 
to  Denmark,  was  made  to  sleep  in  the  same 
room  with  a   woman   in   the   last    stages   of 


Saxatoria  sf.f.x  from  the  Xokwegiax  Fjords 

tuberculosis.  When  one  considers  the  ex- 
treme crowding  of  passengers  in  the  steerage, 
the  shutting  up  of  a  young  girl  for  twelve 
days  with  a  case  of  advanced  tuberculosis 
seems   little    short   of   criminal. 

15 


MEDICAL  EUROPE 

The  fjords  of  Norway,  seen  for  the  first 
time,  are  beautiful.  Neat  little  villages  with 
red-tiled  roofs  are  set  at  intervals  in  the  black 
and  green  of  the  hills.  The  first  of  May  is 
warm,  as  warm  as  St.  Louis  at  the  same  time 
of  year,  which  is  a  surprise  to  many  travellers. 
Norway  is  a  favorite  country  for  summer 
travel,  in  this  respect  rivalling  Switzerland, 
which  it  is  not  unlike. 

We  stopped  at  Christiansand, — a  painted 
stage  picture  in  chiaro-oscuro  in  the  early 
morning  light, — but  a  few  minutes,  to  debark 
passengers.  I  would  have  liked  to  have 
stayed  for  weeks.  Then  we  steamed  down  the 
fjord  to  Christiania,  and  the  dark-browed  hills 
that  saw  the  fleeing  of  the  Finns  before 
Harald  Harfagar  and  Erik  the  Cruel,  looked 
down  on  us. 

Those  were  great  old  fellows,  the  Norse- 
men. Back  in  my  school-boy  days,  I  remem- 
ber I  used  to  declaim  with  great  gusto  the 
"Skeleton  in  Armor," — and  dream  of  those 
old  chaps. 

"Many  a  \Yassail-bout 
Wore  the  long  Winter  out; 
Often  our  midnight  shout 
Set  the  cocks  crowing 
As  we  the  Berserk's  tale  • 

Measured  in  cups  of  ale, 
Draining  the  oaken  pail. 
Filled  to  o'erflowing. " 

16 


CHRISTIAXIA 


rler    1] 


of    them    died    from 


1    wonder    now    many 
cirrhosis  of  the  liver. 

Christiania  is  a  sleepy  looking  town,  but 
has  all  the  modern  improvements.  Frederick 
VI  founded  the  University  here  in  1811,  and 
we  found  it  still  flourishing.  As  our  time  was 
limited  we  pitched  a  penny  to  determine 
whether  we  would  see  a  surgical  clinic,  or  the 


Oslo  Hospital— Christiania 


Viking  Ship  which  is  the  main  attraction  of 
the  Museum.  The  Viking  Ship  won.  This 
most  interesting  and  awe-inspiring  mass  of 
kindling  wood  is  adequately  described  by 
Baedeker,  so  I  won't  rave  about  it  here. 

Of  most  interest  to  medical  men,  perhaps, 
are  the  numerous  sanatoria  for  tuberculosis 
which  are  situated  in  the  neighborhood  of 
Christiania.  At  Holmenkollen  one  grets  a  g^ood 
idea  of  the  situation  and  style  of  these  institu- 

2  17 


MEDICAL  EUROPE 

tions.  Holmenkollen  is  reached  by  trolley  car, 
plus  a  short  walk,  from  Christiania  at  an 
expense  of  ten  cents.  The  road  is  cut  for  a 
great  part  through  the  living  rock.  A  beauti- 
ful view  of  Christiana  and  its  harbor,  and  an 
excellent  lunch  at  the  Holmenkollen  Hotel, 
can  be  had  before  visiting  the  sanatoria. 

Tuberculosis  is  treated  here,  as  everywhere 
else,  by  fresh  air,  sunshine,  and  wholesome 
food.  And  I  have  never  seen  a  place  where  I 
thought  the  combination  could  be  more  enjoy- 
ably  obtained  than  here.  In  the  winter  the 
hemlock  boughs  of  the  surrounding  forest  are 
weighted  with  snow,  and  huge,  high  snow- 
banks at  times  block  the  road  that  leads  up 
the  mountain.  But  the  sun  shines  ever  in 
at  the  great  broad  glass  windows  of  the 
enclosed  piazzas. 

A  little  distance  back  of  the  hotel  is  the 
course  for  the  ski  races  which  are  held  here 
annually.  It  makes  one  shiver  just  to  look 
at  that  precipitous  mountainside,  with  the 
big  "set  off"  about  half  way  down  that 
throws  a  man  into  the  air  thirty  to  forty  feet. 
I  have  heard  of  Americans  "getting  skates 
on,"  but  if  Norwegians  ever  "get  ski's  on" 
they  must  have  an  awful  time  explaining  to 
their  wives  the  next  morning. 

We  were  dropped  down  the  mountainside 

18 


HOLMEXKOLLEX 

safely  })y  our  faithful  trolley,  and  as  the 
cottonseed  oil  and  lard  that  are  imported  for 
the  manufacturing  of  "pure  Danish  creamery 
})utter"  were  unloaded,  we  climbed  back  on 
board  our  ship,  and  steamed  out  into  the 
fjord  on  our  way  to  Copenhagen. 


II. 

COPENHAGEN FABER      AND      ROYSING, HOS- 
PITALS AND   HOSPITAL  MANAGEMENT. 

It  was  a  glorious  morning  that  saw  us 
entering  the  harbor  of  Copenhagen,  which  is 
one  of  the  prettiest  of  all  the  harbors  of 
Europe.  Over  to  the  right  the  castle  of 
Elsinore,  the  manor  of  the  mythical  Hamlet, 
had  been  pointed  out  to  us.  "You  can't  see 
the  pile  of  stones  that  marks  his  grave  yet," 
said  the  deck  steward,  "but  they  will  pile 
them  up  before  the  tourist  season  opens. 
The  tourists  carry  off  so  many  that  they 
have  to  make  a  new  pile  each  year." 

As  I  was  standing  by  the  rail  a  fair-haired 
Dane,  who  had  sat  at  my  table,  came  to  say 
good-bye.  "Are  you  abroad,  like  all  the  rest, 
just  to  travel.^"  she  asked.  "No,"  I  replied; 
"I  came  for  two  very  serious  purposes.  First 
of  all,  to  secure  a  broader  medical  education; 
and,  second,  to  make  other  acquaintances  as 
pleasurable  as  ours  has  been." 

"That  is  a  very  nice  thing  to  say,"  she 
replied.  "But  I  don't  see  the  seriousness  of 
the  first  purpose." 

Copenhagen,    the    capital    of    Denmark,    a 


09 


COPENHAGEN 

busy  city  of  some  half  a  million  or  more 
inhabitants,  has  eight  municipal  hospitals. 
The  largest  is  the  Kommunehospltal,  with 
a  thousand  beds.  There  are  two  hospitals 
for  tuberculosis,  one  for  infectious  diseases, 
and  so  on.  It  is  needless  to  say  that  these 
institutions  are  used  for  teaching  purposes, 
and  the  chiefs  of  departments  are  professors 
in  the  University.  All  European  hospitals 
fulfil  three  functions:  care  of  the  sick,  teach- 
ing, and  research.  Every  ward  in  every 
hospital  has  its  laboratory.  In  addition,  there 
is  a  main  laboratory.  If  patients  have  money 
they  pay  for  their  treatment.  The  prices 
range  from  fifty  cents  to  a  dollar  a  day,  ac- 
cording to  the  circumstances  of  the  patient. 
Those  who  are  poor  do  not  pay.  Whether 
one  pays  or  does  not  pay  one  is  put  in  the 
same  ward.  All  are  treated  absolutely  and 
exactly  alike. 

It  might  be  mentioned.  In  passing,  that  all 
the  medical  men  we  met  In  Copenhagen  were 
apologetic.  They  seemed  to  think  their  insti- 
tutions were  inadequate.  "  If  you  come  again 
in  two  or  three  years,  you  will  see  our  great 
new  public  hospital  that  is  now  being  built," 
they  told  us. 

The  courteous  manner  in  which  we  were 
treated  everywhere  in  Denmark  made  us  feel 

23 


MEDICAL  EUROPE 


embarrassed  at  times.  From  the  humble  gate- 
keeper of  a  hospital  to  the  chief  of  service, 
eYer^i:hing  was  done  that  could  be  done  to 
show  us  what  we  desired  to  see.  The  Danes, 
without  exception,  will  go  out  of  their  way  to 
show  a  foreigner  a  favor.  You  are  the  guest 
of  the  man  you  speak  with.  You  need  no 
letters  of  introduction.     An  unknown  Ameri- 


Fkiedebik's  Hospital — Copenhagen 


can  country  practitioner  would  be  shown  the 
same  consideration  as  an  acknowledged  leader 
of  the  profession. 

Our  first  visit  was  to  the  Friederik's  Hos- 
pital. This  is  the  oldest  hospital  in  the  city. 
It  was  built  in  1752,  over  one  hundred  and 
fiftv  years  ago,  and  yet  it  is  in  remarkably 
good  condition,  and  in  its  hygienic  construc- 
tion is  far  ahead  of  many  of  our  modern  insti- 
tutions.   This  hospital  has  about  six  hundred 

24 


COPENHAGEN 

beds,  and  the  patients  in  their  pink  checkered 
pajamas,  with  their  individual  sponge  and 
tooth-brush  at  the  head  of  each  bed,  look 
remarkably  clean  and  happy. 

Here  it  was  we  met  Faber  and  Rovsing,  the 
leaders  in  Denmark  in  medicine  and  surgery 
respectively.  Professor  Faber  has  the  clean, 
kindly  face,  with  little  wrinkles  at  the  corners 
of  the  eyes,  that  is  common  to  so  many  men 
who  have  successfully  combated  disease.  In 
the  depths  of  his  blue  eyes  lurks  also  a  trace 
of  humor  that  makes  one  think  of  Osier. 

We  made  a  round  of  the  wards  with  Faber, 
accompanied  by  the  usual  retinue  of  assistants 
and  nurses,  and  noticed  nothing  in  his  manner 
of  handling  the  patients  that  differed  from  the 
ordinary  routine  of  one  of  our  better  class 
American  hospitals. 

Povsing,  of  whom  everybody  speaks  as  the 
admitted  leader  of  surgery  in  Denmark,  is  a 
splendidly  built,  handsome  man,  with  blond 
curly  hair  and  moustache.  He  is  a  worker, 
and  there  are  lines  in  his  face  that  show  it. 
The  day  we  met  him  he  had  begun  operating 
at  eight  o'clock  in  the  morning;  he  was  still 
operating  when  we  left  the  hospital  at  one 
o'clock,  and  he  had  three  major  kidney 
operations  yet  to  do  at  his  private  hospital 
in    the    afternoon.     The    sun     sets     late    at 

25 


MEDICAL  EUROPE 


Copenhagen    in    May,    and   one   can   put   in 
many  hours'  work  a  day. 

We  watched  Rovsing  do  an  appendix  oper- 
ation. It  is  not  uncommon  for  medical  men 
who  return  from  Europe  to  say  there  is  no 
surgery  there.  They  should  see  Rovsing 
operate.  His  technique  compares  favorably 
with  that  of  any  American  surgeon  you  care  to 


f4l 


/-  .^ 


^^.M'h^:* 


V 


mention.  He  is  swift  and  skilful.  He  has  his 
details  arranged  to  a  nicety  that  is  astonish- 
ing, and  his  assistants  know  exactly  what  to 
do  without  being  told.  In  addition  he  makes 
his  diagnosis  before  he  operates. 

A  picturesque  feature  of  the  operation  we 
saw  was  the  yellow  oilskins  and  rubber  boots 
of  those  who  participated.  It  made  us  think 
of  the  deck  of  our  ship  in  a  storm.  However, 
we  all  agreed  that  it  was  pretty  work— as 
pretty  work  as  any  of  us  had  ever  witnessed. 


26 


COPENHAGEIS^ 

The  Kommunehospital,  which  we  next  vis- 
ited, is  built  in  the  form  of  the  letter  H,  with 
an  extra  bar  across  the  top.  Inside  are  courts, 
beautiful  with  trees  and  shrubbery  and  flowers 
and  green  grass.  The  buildings  of  the  new 
St.  Louis  City  Hospital  could  be  set  in  one  of 
these  courts,  and  there  would  still  be  some  of 
the  shrubbery  left.     This  hospital  was  erected 


jMumcipal  Hospital — Copenhagen 


in  1863,  but  is  essentially  modern  in  all  partic- 
ulars, except  for  the  fact  that  in  many  of  the 
wards  there  are  stoves.  The  hospital  has  a 
central  heating  plant,  but  somehow  or  other 
they  do  not  manage  those  things  well  over 
here.  If  one  wants  a  good  equable  warmth 
one  must  have  a  stove. 

In  general,  hospital  management  here  is  the 
same  as  in  the  United  States.  One  thing, 
however,  may  be  mentioned.    There  is  a  ward 

27 


MEDICAL  EUROPE 

here  for  delirium  tremens,  but  in  it  are  no 
iron-barred  doors,  no  thick  leather  straps,  and 
no  strait-jackets.  The  ward  is  the  same  as 
the  other  wards,  except  that  in  connection 
with  it  there  is  a  drawing-room  with  plush- 
upholstered  furniture  and  a  piano.  Then 
there  is  a  garden  enclosed  by  a  high  fence, 
where  convalescents  may  walk. 

"But  what  do  you  do  when  the  D.  T.'s  are 
violent.^"  I  asked.  "Don't  you  ever  strap 
them  down  ?'' 

"We  never  use  any  force,"  was  the  reply. 

Now  I  don't  know  anything  about  handling 
such  cases,  but  as  I  had  seen  the  iron-barred 
doors  and  straps  in  St.  Louis,  and  in  Boston 
had  seen  a  burly  policeman  jump  on  a  man's 
abdomen  with  both  knees  and  throttle  him 
till  he  was  black  in  the  face,  while  the  house 
officers  were  putting  on  the  strait-jacket,  I 
admit  I  was  surprised.  If  ever  I  become 
an  alcoholic,  I  think  I'll  take  my  treatment 
over  here. 

Another  feature  of  this  hospital  is  the  ear, 
nose,  and  throat  clinic  of  Professor  Mygind, 
which  is  new.  Mygind  himself  is  a  large, 
rather  stern-appearing  man,  at  first  glance. 
But  his  face  lights  up  when  a  child  approaches, 
and  it  was  delightful  to  see  tlie  kindly  way  he 
petted   the   children   in   liis   ward.      There   is 

28 


COPENHAGEN 

probably  no  better  equipped  clinic  of  its  kind 
in  the  world  than  this  of  Mygind's.  Every- 
thing is  absolutely  new  and  of  the  best.  lie 
waited  till  he  could  have  everything  he  wanted 
before  he  allowed  the  erection,  and  we  saw 
here  dozens  of  new  ideas,  many  of  them 
original.  Dr.  Mygind's  assistant,  Dr.  Hald, 
is  an  especially  prepossessing  young  man.  We 
watched  him  do  a  paraffin  injection  to  fill  up 
a  hole  in  the  forehead  of  a  man  who  had  fallen 
some  fifty  feet  and  pushed  the  whole  of  his 
forehead  over  to  one  side.  The  man  left 
happy  after  the  injection,  with  a  symmetrical 
face  and  the  brow  of  a  Jupiter.  Dr.  Hald 
told  us  that  men  were  much  more  particular 
about  the  appearance  of  their  faces  than 
women.  In  fact  that  most  of  his  "beauty 
patients"  were  males.  He  had  just  fixed  up 
a  horse-dealer  who  insisted  on  viewing  the 
operation  on  himself  with  a  mirror  and  con- 
trolling results  by  his  own  suggestions. 

Withal,  we  were  royally  treated  here.  We 
were  the  guests  of  the  staff  at  dinner.  In  a 
neat  speech  they  thanked  us  for  our  interest, 
and  extended  the  good  feeling  of  Denmark 
for  America.  We  were  too  embarrassed  to 
respond  fittingly,  I  fear,  but  there  will  always 
be  a  warm  spot  in  our  hearts  for  the  doctors 
of    the    Kommunehospital.      We    shall    carry 

29 


MEDICAL  EUROPE 

back  to  America  and  keep  always  the  memory 
of  our  visit,  including  the  coffee,  and  punsch, 
and  cigars,  in  the  garden. 

''  SkaaV  to  Denmark,  and  Copenhagen,  and 
the  doctors  we  met  at  the  Kommunehospital ! 

The  house  physicians  in  Denmark  hospitals 
are  mature.  A  medical  course  in  Denmark 
takes  six  years.  Then  it  is  necessary  to  sig- 
nify one's  desire  for  a  hospital  appointment 
early  in  one's  career  and  to  wait  for  a  va- 
cancy. Men  are  frequently  out  five  or  six 
years  before  they  receive  their  appointments. 
There  is  no  danger  here  of  a  patient  in  a 
municipal  institution  falling  into  unskilled 
hands.  Not  only  is  there  skill  and  efficiency, 
but  there  is  universal  kindness  used  in  the 
handling  of  patients.  There  is  always  a  kind 
word  and  a  smile;  a  pat  on  the  shoulder  or  a 
grasp  of  the  hand  for  the  patient.  We  saw  a 
lodgekeeper  put  his  arm  about  a  ragged 
urchin  who  had  lost  his  way,  and  lead  him  to 
the  ward  he  desired,  and  the  doctor  met  him 
with  a  smile,  and  the  nurse  beamed  on  him. 
And  we,  outside  in  the  warm  sunshine  of  the 
court-yard  looked  at  each  other,  but  we  were 
silent. 


III. 

MORE       ABOUT       COPENHAGEN THE       FINSEN 

INSTITUTE  AND  ITS  FOUNDER. 

A  VISIT  to  Copenhagen  is  not  complete, 
even  if  you  are  not  medically  inclined,  with- 
out a  view  of  the  Finsen  Institute.  There  is 
probably    no    name    more    generally    known 


throughout  Scandinavia  than  that  of  Niels 
Finsen.  There  is  probably  no  remote  hamlet, 
tucked  away  in  the  interior  of  Denmark,  that 
does  not  contain  some  individual  who  can 
testify  to  the  efficacy  of  the  Finsen  light  in 
the  treatment  of  lupus. 

When    Finsen    died    here    in    Copenhagen 

31 


MEDICAL  EUROPE 

on    September  24,   1904,  the  Journal  of    the 
A.M. A.  printed  the  following  editorial: 

"In  the  death  of  Niels  R.  Finsen  there 
passed  away  one  of  the  heroic  figures  in 
modern  medicine.  In  spite  of  chronic  and 
incurable  disease,  Finsen,  with  rare  persist- 
ence, developed  phototherapy  on  a  strictly 
scientific  basis  so  that  it  became  definitively 
established  as  a  successful  means  of  cure  in 
lupus  vulgaris.  He  early  recognized  that  if 
the  great  forces  contained  in  light  ever  could 
be  used  in  the  science  of  practical  medicine 
it  would  result  only  from  investigations  of 
physical,  chemical  and  biologic  nature,  to- 
gether with  practical  experiments  in  different 
diseases.  Apparently,  his  earliest  publica- 
tions concerning  light  and  its  action  on  the 
animal  organism  date  from  1893.  In  1896 
the  results  of  his  scientific  researches  led  to 
the  establishment  in  Copenhagen,  as  the  out- 
come of  private  and  public  support,  of  *  Fin- 
sen's  Medical  Light  Institute.'  Subsequently 
this  institute,  which  soon  became  known 
everywhere,  was  greatly  enlarged.  In  1899 
Finsen  began  the  issue  of  a  series  of  reports 
{Meddelelser  fra  Finsen' s  medicinske  Lysin- 
stitue)  in  which  are  published  the  results  of 
the  scientific  and  practical  work  of  the  insti- 
tute.    In  the  meantime,  there  appeared  im- 

32 


COPE  XII AGEX 

portant  monographs  by  Finsen  in  the  Danish, 
French,  and  German  languages.  Here  were 
considered  especially  the  role  of  the  chemical 
rays  of  light  in  medicine  and  in  biology,  and 
the  treatment  of  lupus  vulgaris  by  concen- 
trated chemical  rays.  The  report  covering 
the  first  800  cases  of  lupus  vulgaris  treated 
at  Finsen's  institute  (November,  1895,  to 
November,  1901,)  shows  that  407  were  cured, 
85  had  interrupted  the  treatment,  while  308 
were  still  under  treatment.  This  report  may 
be  taken  as  a  model  of  thoroughness  and 
exactness  in  dealing  with  matters  of  this  kind; 
one  is  particularly  impressed  with  the  careful- 
ness to  avoid  premature  and  exaggerated 
statements  as  to  the  value  of  the  method. 
To  Finsen  belongs  the  credit  of  having  placed 
phototherapy  on  a  firm  and  scientific  basis. 
But  no  one  must  think  for  a  moment  that  this 
was  accomplished  without  persistent  effort. 
In  reading  Finsen's  writings  and  the  publica- 
tions of  others  working  in  his  institute,  one 
at  once  finds  the  keynote  to  the  continuous 
extension  of  our  knowledge  of  the  action  of 
light  on  living  matter,  and  improvements  in 
the  practical  application  of  the  chemically 
active  rays.  Finsen  was  ever  conservative  in 
his  own  estimation  of  the  therapeutic  powers 
of   light,    and   never   advanced   claims   which 

3  33 


MEDICAL  EUROPE 

subsequently  proved  to  be  without  adequate 
foundation.  In  his  short  but  fruitful  career, 
Fin  sen  consistently  illustrated  that  unselfish- 
ness and  modesty  which  medical  men  love  to 
see  in  their  best  types.  He  cared  not  for 
personal  gain.  When  he  was  awarded  the 
Nobel  prize  in  medicine,  in  December,  1903, 
he  generously  turned  the  money  received 
over  to  the  use  of  the  institute.  From  what- 
ever side  we  look  at  Finsen  and  his  work, 
there  comes  only  the  impression  of  a  noble 
character. " 

The  ultraviolet  rays  are  too  well  known  to 
need  description  here,  but  the  manner  of 
their  use  is  interesting  to  the  visitor  who  sees 
them  applied  for  the  first  time. 

The  Finsen  Institute  is  located  amid  the 
shady  boughs  of  great  trees  in  the  edge  of 
the  town.  About  it  are  numerous  private 
villas.  Rovsing's  clinic  is  nearby.  The  insti- 
tute consists  of  only  two  buildings;  one,  the 
laboratory,  is  an  old  villa.  The  clinic  build- 
ing was  especially  built  for  Finsen's  work. 
At  the  left,  as  one  enters  the  grounds,  is  a 
little  low  red  building  that  one  does  not  notice 
until  attention  is  called  to  it.  This  was  the 
place  where  Finsen  first  worked  out  his  ideas. 
The  building  was  brought  here  from  another 
part  of  the  city,  and  serves  as  a  memento  of 

34 


COPENHAGEN 

the  beginning  of  Finsen's  efforts.  If  you  enter 
the  cHnic  suddenly  you  are  somewhat  startled 
at  first.  There  are  perhaps  half  a  hundred 
patients  in  the  big  room,  waiting  their  turn 
at  the  light  machines.  The  faces  you  en- 
counter make  you  shudder.  It  is  like  a  first 
view  of  Boleslas  Biega's  sculpture.  Even  the 
white,  expressionless,  cicatricial  faces  of  the 
cured  cases  one  has  to  get  used  to.  But  the 
horrible  disfigurement  of  advanced,  untreated 
lupus  vulgaris  is  terrible.  One  face  was  a 
blank,  reddish-white  mass,  ringed  with  two 
pink  circles,  from  which  dull  eyes  glanced 
staringly;  there  was  no  nose,  and  a  ragged 
hole  with  everted,  granular  border,  served  for 
mouth.  No  wonder  they  honor  the  name  of 
Finsen,  when  he  has  given  to  his  people  the 
means  whereby  so  hideous  a  human  being 
can  be  restored  to  a  fair  semblance  of  his 
original  self. 

The  patients,  many  of  whom  have  come 
from  distant  parts  of  the  globe,  are  first  photo- 
graphed and  then  seen  by  a  physician,  who 
rings,  with  a  wax  pencil,  the  exact  spot  to 
which  the  light  is  to  be  applied.  Then  they 
are  taken  to  the  operating-room  for  treatment, 
after  which  a  simple  ointment  and  a  bandage 
are  applied.  That  is  all.  Some  cases  need 
only  a  few  treatments,  others  must  remain  for 

35 


MEDICAL  EUROPE 

many  weeks.  Patients  are  advised  to  come 
back  in  six  months  or  a  year  to  have  some 
spots  that  may  have  escaped  the  rays  cleaned 
up.  Each  treatment  costs  from  fifty  cents  to 
a  dollar  according  to  the  circumstances  of  the 
patient.  Although  the  institute  is  a  privately 
conducted  affair  it  receives  aid  both  from  the 
city  and  state.  Most  of  the  Danish  townships 
pay  for  the  treatment  of  the  cases  they  send. 

A  pleasant-faced  lady,  who  speaks  excellent 
English,  and  who  has  much  the  appearance  of 
an  American  school-teacher,  has  charge  of  the 
operating-room.  There  are  seven  of  the  light 
machines  in  the  room.  Six  are  kept  in  use, 
and  one  is  taken  apart  and  cleaned  each  day. 
Each  of  the  machines  consists  of  a  central 
electric  arc  which  furnishes  light  for  four  long 
brass  tubes  fitted  with  quartz  lenses.  A  bed 
on  which  the  patient  lies  is  wheeled  under 
each  tube,  and  a  lady  assistant  is  provided 
for  each  patient.  The  ringed  area  on  the  face 
of  the  patient,  to  which  the  rays  are  to  be 
applied,  is  first  covered  with  a  water  compress, 
to  prevent  burning,  and  then  the  light  is  kept 
constantly  on  the  spot  by  the  attendant  for 
one  hour. 

The    lady    attendants    are    all    remarkably 
good-looking.     I  asked  Dr.  Busk  whether  they 
were  especially  selected  for  therapeutic  pur- 
se 


COPENHAGEN 


poses,  and  suggested  that  I  would  not  mind 
having  lupus  myself  for  an  hour  with  such 
attendants.  Dr.  Busk  said  that  a  great  many 
patients  found  their  fate  here.  I  could  readily 
see  how  such  might  be  the  case.  Take  a  man, 
who  for  cosmetic  reasons,  has  probably  kept 
himself  away  from  society  for  a  long  time,  and 
let  him  find  himself  the  fortunate  possessor  of 
a  new  face,  into  which  a 
charming  young  lady  looks 
steadily  for  an  hour  each 
day,  is  it  unreasonable  that 
he  should  ask  the  charming 
lady  if  she  would  always  look 
into  his  new  face  across  the 
breakfast-table  ? 

In  addition  to  the  Finsen 
light  there  is  a  room  for  Ront- 
gen-ray  treatment  here  and  a 
room  for  universal  light  baths.  The  latter  are 
given  by  means  of  an  arc  light  of  120  amperes. 
Preparation  for  the  bath  consists  only  in  the 
substitution  of  a  pair  of  automobile  goggles  for 
one's  ordinary  raiment.  Experiments  which 
have  been  carried  on  in  the  Finsen  laboratory 
seem  to  show  that  this  universal  light  bath  will 
prove  efficacious  in  the  treatment  of  chronic 
cardiac  affections,  and  a  new  building  is  soon 
to  be  built  especially  for  this  treatment. 

37 


MEDICAL  EUROPE 

The  laboratory  of  the  Einsen  Institute  is 
well  equipped,   and  general  research  is  con- 
stantly carried  on  by  several  trained  labora- 
tory workers.     Dr.  Busk,  who  took  us  about, 
is  a  young  man,  enthusiastic,  a  worker  and  a 
cosmopolite.    He  knows,  it  seems,  all  the  cities 
of  the  world.     He  told  us  that  an  x\merican 
medical    concern   some  years   ago  advertised 
Einsen-light  treatment.     They  claimed  to  be 
working  in  cooperation  with  Dr.  Finsen  and 
to   be   backed   by   the    Danish    Government. 
As  a  matter  of  fact  they  were  not  using  the 
Finsen   light    and   of   course   their   treatment 
amounted  to  nothing.     Dr.  Busk  said  that  he 
tried  to  get  a  denial  printed  in  some  of  the 
leading  newspapers,  but  they  were  too  busy 
apparently  to  print  it.     We  explained  to  him 
that  looking  after  the  business  of  their  adver- 
tisers did  keep  the  American  newspapers,  as 
a  rule,  very  busy. 


IV. 

STOCKHOLM THE  HOME  OF  GREAT  INVENTORS 

NOTEWORTHY  MEDICAL  INSTITUTIONS. 

If  one  has  time  to  spare  there  is  no  better 
way  of  kilHng  it  than  by  taking  the  trip  by 
water  from  Copenhagen  to  Stockholm,  up  the 
coast  and  through  the  canals  which  cross 
Sweden.  One  takes  a  boat  up  the  Kattegat 
to  Gottenburg,  passing  on  the  way  the  fine 
old  castle  of  Kronborg,  built  by  Frederick  II. 
From  here  to  Stockholm  the  canal  trip  takes 
about  three  days. 

The  direct  route,  which  we  took,  is  only  a 
night's  journey  by  boat  to  Malmo  and  thence 
by  train  to  Stockholm.  These  night  trains 
are  managed  simply  in  Europe.  The  back  of 
the  seat,  that  forms  one  side  of  the  compart- 
ment, is  pushed  up  to  make  a  shelf.  You  get 
on  to  the  shelf,  and  that  is  all  there  is  to  it. 
There  may  be  a  lady  on  the  next  shelf,  but 
nobody  seems  to  mind. 

We  did  not  sleep  very  well  on  our  shelves, 
and  so  landed  in  Stockholm  in  a  rather  bad 
humor.  My  feelings  were  not  improved  by 
the  unkind  remark  of  my  friend,  who  referred 
to  my  nether  garments  as  '*  accordion-pleated 

39 


MEDICAL  EUROPE 

trousers."  However,  a  brush  up  and  a  pot  of 
excellent  coffee  at  the  Rysdale  soon  put  us 
to  rights  and  we  were  ready  for  adventure. 

A  man  who  had  travelled  much  told  us  that 
to  him  Stockholm  was  one  of  the  three  finest 
cities  in  the  world.  The  other  two  places  he 
mentioned  were  Edinburgh  and  Hong-Kong. 
I  have  never  been  to  all  the  cities  in  the  world 
and,  unfortunately,  I  have  never  seen  either 


The  l;iii  al  Palate — Stockholm.     St.  Petkesbukg  Steamer  at  i.ekt 

of  the  two  latter  places,  so  I  am  not  in  a  posi- 
tion to  pass  judgment.  However,  I  can  truth- 
fully affirm  that  Stockholm  is  a  fine  city.  It 
is  less  clean  than  Berlin,  less  beautiful  than 
Budapest,  less  interesting  then  Prague,  and 
less  picturesque  than  Venice.  But  it  has  one 
product  that  makes  it  stand  out  distinctly 
above  all  these  other  cities,  and  that  is  its 
Caloric  Pwisch. 

I  never  knew  what  it  could  have  been  that 
made    the    chap    in    "Hedda    Gabler"    have 

40 


STOCKHOLM 

"vine  leaves  In  his  hair"  until  I  visited 
Scandinavia.  Now  I  know  Ibsen  must  have 
referred  to   Swedish  punch. 

The  300,000  people  who  live  here  are  un- 
doubtedly proud  of  their  islands,  their  plains, 
and  their  rocky  hills,  which  serve  to  make  this 
"Venice  of  the  North"  so  picturesque. 

Compared  with  many  European  towns 
Stockholm  is  modern,  for  the  settlement  was 
not  founded  till  1255,  and  it  was  not  until 
1857  that  the  old  wooden  houses  were  replaced 
by  the  present  stone  structures.  Probably, 
therefore,  Berzelius,  the  great  chemist,  whose 
statue  stands  in  the  little  park  which  bears 
his  name,  at  the  end  of  the  Hamun-Gatan, 
never  knew  the  discomforts  of  these  later 
edifices. 

One  of  the  first  things  we  did  in  Stockholm 
was  to  look  up  the  headquarters  of  the  Nobel 
Fund,  which  we  found  in  a  building  with  an 
odd  copper-covered  tower  near  the  Observa- 
tory. "It  wouldn't  do,"  one  of  our  party 
remarked,  "not  to  know  exactly  where  to 
come  when  our  turn  arrives  for  receiving 
the  Nobel  Prize."  So  we  sauntered  up  the 
Observatorii-Gatan  and  stood  before  the 
building,  trying  to  imagine  how  it  would  feel 
to  be  making  a  speech  of  acceptance  to  some 
twenty  or  thirty  thousand  dollars,  while  the 

41 


MEDICAL  EUROPE 

telegraphs  and  cables  were  flashing  our  fame 
around  the  world. 

Stockholm  seems  to  have  been  a  great 
place  for  inventors.  There  was  Nobel,  who 
first  invented  dynamite  and  then  invented  a 
peace  prize  to  counteract  it;  there  was  John 
Ericsson,  who  invented  the  screw  propeller, 
which  enables  us  to  come  to  Europe  so  easily 
and  so  quickly;  and  there  was  Sheele,  the 
discoverer  of  oxygen,  hydrofluoric  and  tartaric 
acid;  all  brought  up  in  this  crook  of  the 
Baltic. 

The  hospitals  of  Stockholm  deserve  as  high 
a  place  as  those  of  any  city  in  Europe.  Even 
after  the  surprise  we  got  in  Copenhagen,  we 
were  forced  to  admit  that  the  medical  insti- 
tutions here  were  fully  as  noteworthy  as  in 
the  latter  city.  Many  of  the  larger  medical 
buildings  are  situated  at  Kungsholmen,  a  West 
suburb  of  the  city.  Here  are  to  be  found  the 
Karolinska  Mediko-Kirurgiska  Institut,  which 
was  erected  in  1811,  for  the  practical  training 
of  physicians.  Here,  also,  is  a  large  lying-in- 
hospital;  a  military  hospital;  the  infirmary 
of  St.  Goeran,  and  the  Sjukhem;  and  the 
Conradsberg  lunatic  asylum. 

In  another  part  of  the  city  we  found  Sab- 
batsberg,  a  big,  up-to-date  municipal  hospital, 
beautifully    situated,    as    so    many    European 

42 


STOCKHOLM 

hospitals  are,  in  the  midst  of  extensive 
grounds,  where  there  were  no  "Keep  off  the 
Grass"  notices  for  convalescent  patients. 

But  it  Is  tiresome  to  walk  througli  hospitals 
day  after  day,  and  tiresome  to  write  about 
them  afterwards;  so  I  may  perhaps  be  par- 
doned If  I  merely  say  that  If  you  are  sick 
there  is  a  bed  In  a  hospital  for  you  In  Stock- 
holm (you  may  pay  seventy-five  oere, — i.e., 
twenty-one  cents  a  day,  for  It  if  you  are 
wealthy,  or  you  can  get  it  free  if  you  are  not). 
I  will  speak  of  the  food  to  be  found  here. 
Instead  of  the  hospitals. 

"Americans  enjoy  making  money,"  said  a 
Swede  to  me;  "Swedes  enjoy  spending  It." 
And  he  added,  "x\merlcans  know  how  to 
work;    Swedes  know  how  to  eat." 

Four  of  us  Americans  travelled  together  in 
Sweden,  and  one  of  the  party  was  fortunate 
enough  to  know  a  former  Chicago  man  (a 
Swede)  who  now  lives  In  Stockholm.  This 
man  Invited  us  to  a  Swedish  dinner. 

Now  a  Swedish  dinner  begins  with  Aqua- 
Vitce  and  Pilseiier,  and  ends  with  Caloric 
Punsch,  and  there  are  many  things  In  between. 
I  should  not  like  to  be  assigned  the  writing 
up  of  such  a  dinner,  and  be  required  to  have 
my  copy  in  for  the  next  day's  paper.  I  would 
rather  do  my  writing  for  a  monthly  magazine. 

43 


MEDICAL  EUROPE 

''  Smoergos  hord/'  with  wliicli  one  begins  a 
meal,  is  similar  to  a  Icalter  aufschnitt  or  hors 
cVoeuvres,  and  is  composed  of  any  old  thing 
that  happens  to  be  lying  about  handy.  It 
includes  many  varieties  of  cold  meats,  and 
fish,  caviare,  sardines,  j)ickles,  salads,  jellies 
and  cheeses.  (At  one  dinner  I  had  twenty- 
eight  varieties.)  After  you  have  eaten  enough 
of  this  stuff  to  fill  three  men,  then  dinner 
really  begins.  There  is  soup;  next  the  fish; 
and  then  a  good,  healthy  meat  course — steak, 
pork  chops,  or  what  not.  On  top  of  this  a 
dessert,  somewhat  richer  than  New  England 
mince  pie,   is  served. 

As  Mulvaney  might  say:  "  'Tis  scand'lus." 
But  this  is  not  all.  In  order  to  see  just  how 
much  the  human  organism  can  stand  adjourn- 
ment is  made  to  some  cafe  in  order  to  drench 
the  mass  with  coffee  and  Sw^edish  punch,  and 
to  smoke  big  black  cigars.  I  never  happened 
to  order  Swedish  punch  at  home,  so  I  am  not 
familiar  with  the  way  it  is  served  at  Rector's 
or  the  "Annex,"  but  in  Stockholm  it  is  given 
you  in  much  the  same  manner  that  pink 
lemonade  is  dished  out  at  a  church  sociable. 

The  Opera  House  "Cellar"  is  a  favorite 
place  to  finish  a  dinner.  The  Opera  House 
at  Stockholm  cost  six  and  a-half  million 
krona,   not   including  the   decorations.      The 

44 


STOCKHOLM 

ceiling  of  the  ''Cellar"  cost  twelve  thousand 
krona.  It  is  a  pleasant  place  in  which  to 
finish  a  dinner.  There  is  music,  and  lights, 
and  laughter.  The  music  is  as  good  as  that 
of  the  best  cafes  of  Dresden,  and  a  certain 
Swedish  air  runs  for  about  four  bars  the  same 
as  "My  Old  Kentucky  Home."  "Oh,  the 
sun  shines  bright  in  my — , "  and  I  heard 
some  one  in  our  party  mention  the  "  sad-eyed 


The  Opera  Hiuse  "  <  f.i.laii  " — .- 


cows  standing  knee  deep  in  the  clover. " 
We  extend  the  cordon  bleu  to  the  chefs  of 
Stockholm. 

Oh,  these  dinners  that  we  all  have  eaten, 
both  at  home  and  abroad!  What  delightful 
memories  they  give  us  as  we  look  back  on 
them.  Class  dinners,  wedding  dinners,  society 
dinners;  dinners  partie  carre  and  tete  a  tete. 
There  w^as  the  farewell  dinner  that  our 
friends  gave  us  when  we  sailed,  perhaps. 
Then  there  was  the  Captain's  dinner  on  the 

45 


MEDICAL  EUROPE 

boat  coining  over,  at  which  we  sealed  new 
friendships  that  we  feel  will  last  for  many 
years.  How  many  of  us  remember  a  great 
number  of  the  places  we  have  visited  merely 
because  of  the  food  we  have  eaten  there! 
Berlin  is  simply  Kempinski's  to  us;  Paris  is 
Marguery's  and  Foyot's.  We  don't  care  to  see 
the  Abbey  at  Mount  St.  Michael  again,  but  we 


would  like  to  have  another  of  Madame  Pou- 
lard's omelettes.  Venice  is  recalled,  not  by  the 
canals  and  St.  Mark's,  but  by  that  delicious 
cup  of  coffee  we  got  at  Florian's. 

We  who  perhaps  are  living  in  the  age  of 
Fletcher,  Chittenden,  and  others  who  would 
have  us  lunch  on  a  lettuce  leaf  and  a  glass  of 
Poland  water,  may  be  somewhat  uncertain  of 
the  state  of  our  gastric  mucosa  after  our 
European  dinners.  It  is  well,  at  any  rate,  to 
have  at  home  a  copy  of  Ekkehard,  and  if  you 
have  gastric  misgivings,  turn  to  the  chapter 

40 


STOCKHOLM 

wherein  the  monks  are  entertaining  the  Her- 
zogin  Had  wig  and  read :  ''  Wohl  erschien  zuerst 
ein  dampfender  Hirsebrei.  .  .  .  sich  daran 
ersaettige;  aber  Schuessel  auf  Schuessel  folgte, 
bei  meachtigem  Hirschziemer  fehlte  der  Bae- 
renschinken  nicht,  sogar  der  Biber  vom  obern 
Fischteich  hatte  sein  Leben  lassen  muessen; 
Fasanen,  Rebhuehner,  Turteltaiiben  imd  des 
Vogleherds  kleinere  Ausbete  folgten,  der 
Fische  aber  eine  unendhche  Auswahl,  so  dass 
schhesshch  ein  jeghch  Getier,  watendes,  flie- 
gendes,  schwimmends  und  kriechendes,  auf 
der  Klostertafel  seine  Vertretung  fand. " 

After  which  reading,  one  may  go  to  sleep 
with  a  clear  conscience. 


V. 

UPSALA THE   ROYAL  UNIVERSITY THE  TOMB 

OF  LINN^US. 

The  Royal  University  of  Sweden  is  situated 
at  Upsala,  a  sleepy  old  college  town,  sixty-six 
kilometres  from  Stockholm.  Leaving  Stock- 
holm at  ten  o'clock  in  the  morning  one  can 
see  the  town  and  University  pretty  thoroughly 
and  get  back  at  seven  in  the  evening.  Besides 
the  University  there  is  a  great  Cathedral  at 
Upsala  that  was  begun  before  Columbus 
started  for  America  and  which  has  only 
recently  been  finished.  There  is  also  an  im- 
mense Slott  (which  may  be  translated  palace 
or  castle  as  you  choose).  Both  of  these  are 
worth  the  seeing.  One  can  see  here  also  the 
home  of  Linnseus,  for  here  it  was  the  great 
botanist  lived  and  worked.  The  main  build- 
ing of  the  University,  the  library,  and  the 
students,  with  their  white  velvet  caps  and 
canes,  flitting  about,  constitute  the  chief  at- 
tractions of  the  town  for  ordinary  tourists. 

The  matter  of  making  calls  is  in  many 
instances  a  solemn  one,  but  the  custom  of 
leaving  a  visiting-card  in  the  silver  tray  that 
stands  before  the  black  marble  which  marks 

48 


UP  SAL  A 

the  tomb  of  Linnaeus  was  almost  as  cheer- 
less as  repaying  certain  dinner  calls.  We 
would  not  have  been  surprised  if  the  sacristan 
had  said,  ''Mr.  Linnaeus  is  in,  but  is  not 
receiving."  How  this  unique  custom  of  leav- 
ing your  card  for  the  dead  originated  no  one 


Carl  von  Lixx.txs 


seemed  to  know.  But  cards  are  left  here  by 
the  hundred  each  year,  and  when  the  silver 
tray  is  filled  they  are  filed  away  in  the  library. 
Carl  von  Linnaeus,  the  father  of  Botany, 
died  here  in  Upsala  in  1778.  When  he  first 
came  to  Upsala,  as  a  youth,  his  main  stock  in 
trade  seemed  to  be  a  desire  for  an  education, 
for  it  is  said  that  he  lived  for  many  months 

4  49 


MEDICAL  EUROPE 

on  one  meal  a  day.  Dr.  Celsius,  a  professor 
of  divinity,  happened  to  discover  his  pro- 
ficiency in  botany  and  gave  him  a  start.  He 
made  good  with  such  rapidity  that  his  first 
published  works  aroused  the  jealously  of  the 
Professor  of  Botany,  Dr.  Rosen,  and  upon 
some  pretext  Rosen  had  Linnaeus  dismissed 
from  the  University.  This  dismissal  didn't 
seem  to  affect  Linnaeus'  work,  for  we  soon 
hear  of  him  as  President  of  the  Royal  Acad- 
emy, and  in  1741  he  returned  to  Upsala  to 
take  the  Chair  of  Botany  and  turn  the  laugh 
on  Professor  Rosen. 

While  Linnaeus  was  able  to  make  his 
department  in  the  University  of  Sweden  the 
most  famous  in  the  world,  and  to  keep  foreign 
nations  and  learned  societies  busy  in  con- 
ferring medals  and  degrees  upon  him,  he  was 
never  able  to  classify  his  own  little  home 
herbarium.  His  wife  was  reported  to  be  given 
to  "frivolity  and  dissipation,"  and,  notwith- 
standing the  fame  of  her  husband,  she  was 
finally  denied  admission  to  the  Court.  The 
five  children  of  these  two  incompatibles  went 
for  the  most  part  the  way  of  the  mother, 
although  one  daughter  made  some  important 
experiments  in  plant  life,  and  a  son,  who 
never  did  anything  out  of  the  ordinary,  suc- 
ceeded Linnaeus  at  the  University. 

50 


UPSALA 

Linnaeus  was  apparently  a  man  who  should 
not  have  married,  for  he  did  not  have  the 
happy  faculty  of  mixing  emotion  with  intel- 
lect, and  it  was  undoubtedly  his  neglect  of 
his  wife  that  caused  her  to  seek  companion- 
ship in  those  whose  knowledge  was  less 
cryptogamous  than  her  husband's. 


House  of  Linn^.us 


We  found  the  medical  department  of  the 
University  of  great  interest.  There  are  about 
a  hundred  and  sixty  students  of  medicine  here, 
and  their  needs  are  amply  provided  for.  It  is 
interesting  to  compare  some  points  in  the  med- 
ical training  here  with  those  at  home.  Take, 
for  instance,  the  course  in  pathology.  The 
student  here  has  pathology  rubbed  into  him 

51 


MEDICAL  EUROPE 

for  three  years,  and  he  can  get  more  if  he 
wishes.  There  is  a  large  building  devoted 
wholly  to  pathology.  It  contains  lecture- 
rooms,  museum,  post-mortem  room,  and  nu- 
merous rooms  for  individual  research.  There 
are  two  professorships  in  this  subject.  Ulrik 
Quensel,  wdio  is  chief  of  the  department,  is  a 
pleasant  man  to  meet.  He  has  a  pleasing 
smile  and  a  nice  little  way  of  throwing  back 
his  head  when  he  laughs,  which  he  does  fre- 
quently. All  the  time  he  was  showing  us 
about  he  held  tenaciously  to  the  butt  of  a 
small  cigar.  There  was  perhaps  two  centi- 
metres of  it  in  all.  Occasionally  he  would 
manage  to  get  the  end  of  it  in  the  corner  of 
his  mouth,  but  would  withdraw  it  quickly 
and  look  at  it  reproachfully.  I  could  almost 
fancy  he  was  chiding  it  for  not  giving  him  a 
longer  smoke.  Professor  Vealberg,  who  has 
the  chair  of  experimental  pathology,  is  a  short, 
somewhat  fat,  enthusiastic  man.  Rather  quick 
in  his  actions,  he  is,  as  the  Germans  would  say, 
not  possessed  of  sitzfleisch.  The  students  at 
Upsala  are  surely  getting  lots  of  good  path- 
ology under  these  excellent  men  and  their 
assistants. 

What  is  true  of  pathology  is  no  less  true  of 
the  other  departments.  There  is  a  fine  ana- 
tomical   institute    here,    of    which    Professor 

52 


UP  SAL  A 

Hammar  is  the  head.  It  is  modern  and  finely 
equipped.  In  chemistry,  Hammarsten  is  too 
well  known  to  need  comment.  Most  of  us  w^ho 
have  studied  medicine  at  home  have  used  his 
text-book.  After  we  had  finished  our  round 
of  the  laboratories,  we  were  taken  to  the 
University  Hospital.  This  is  a  large,  roomy 
building,    situated    in    a    beautiful    park,    in 


\  -^ 


1 1 1 

ir~z  '.'^'~~    ""     " 

Anatmmi.  AL  I\-Tn  VI  ]; — {' 


which  convalescents  mav  wander  about  to 
their  hearts'  content.  The  hospital  has  some- 
thing over  three  hundred  beds;  patients  are 
drawn  from  all  over  Sweden.  Both  Professor 
Petren,  in  medicine,  and  Lennander,  in  sur- 
gery, were  aw^ay,  so  we  did  not  meet  them,  but 
we  obtained  a  good  idea  of  the  work  that 
was  being  done  here  from  their  assistants. 
Here  at  Upsala  it  was  that  we  had  to  get  out 
our  best  German  and  air  it.     Previously  we 

53 


MEDICAL  EUROPE 

had  conversed  in  English  with  nearly  every- 
one we  met.  It  really  is  remarkable  how 
universally  English  is  spoken  here  in  Scandi- 
navia. 

Again  were  we  surprised  at  the  excellence 
of  the  surgery  here.  Appendicitis  is  very 
common  in  Sweden.  In  one  ward  nearly 
every  patient  was  minus  his  appendix.  Many 
of  the  patients  had  also  a  general  peritonitis. 
We  saw  one  man,  a  student,  who  was  a  monu- 
ment to  the  care  and  skill  of  Swedish  surgery. 
He  had  had  a  gangrenous  appendicitis  with 
diffuse  purulent  peritonitis.  Several  metres 
of  gangrenous  small  intestine  had  been  re- 
moved and  he  had  been  thoroughly  cleaned 
out  and  plenty  of  fistulse  left  so  that  he  would 
have  no  work  to  do  for  himself.  He  was  being 
fed  through  a  gastric  fistula  and  evacuated 
through  a  faecal  fistula.  There  was  also  a 
hepatic  fistula.  It  was  the  third  day  after 
the  operation  that  we  saw  him,  and  he  con- 
versed with  us  in  English.  He  said  he  had  a 
sister  in  Cornell  University,  at  Ithaca,  New 
York.  He  was  being  fed  on  a  well-known 
American  infant's  food.  The  combination 
made  us  feel  much  at  home. 

"We' do  better  surgery  here  in  Scandinavia 
than  is  done  anywhere  else  in  Europe,"  said 
Dr.  Lennander's  assistant  to  us  naively,  "but 

54 


UP  SAL  A 

it  is  hard  work."  And  he  shrugged  his 
shoulders,  as  though  he  thought  the  game 
was  hardly  worth  the  candle. 

Not  the  least  interesting  part  of  our  visit 
to  Upsala  was  Professor  Gullstrand's  eye 
clinic.  Gullstrand  is  a  tall,  thin  man,  not 
handsome,  but  one  who  wins  your  confi- 
dence in  a  very  few  moments  of  conversation. 
You  feel  intuitively  after  being  with  him 
that  you  have  met  a  great  man.  He  spoke 
English.  At  least  he  said,  '*If  you  will  wait 
two  moments,  I  will  dispose  of  you." 

There  is  no  better  eye  clinic  in  all  the  world 
than  this  of  Gullstrand's  in  this  sleepy  old 
town  of  Upsala.  There  is  no  detail  lacking 
in  equipment;  nothing  that  is  not  essentially 
modern;  nothing  but  the  best.  Things  that 
Gullstrand  has  himself  given  to  science  were 
shown  to  us  modestly. 

We  looked  at  ourselves  in  the  uncanny  glow 
of  the  mercury  vapor  light  that  Gullstrand 
uses  for  determining  haemorrhages  of  the 
retina.  We  saw  much  complicated  apparatus 
that  we  were  incapable  of  understanding,  for 
this  laboratory  is  in  truth  a  wizard's  shop. 

On  the  whole  one  may  say  that  Scandi- 
navian medicine  is  as  good  as  the  best.  There 
is  just  as  good  work  being  done  in  America  as 
there  is  here,  but  the  pity  of  it  is  there  is  so 

57 


MEDICAL  EUROPE 

much  bad  work  being  done  in  America.  Here 
there  can't  be  much  bad  work;  the  training 
necessary  to  secure  the  degree  of  doctor  of 
medicine  is  too  severe.  Uniformity  of  train- 
ing is  what  we  lack  at  home.  Surgery  here 
is  as  good  as  American  surgery,  and  that 
means  it  is  way  ahead  of  the  rest  of  Europe. 
General  medicine  I  should  say  was  hardly  up 
to  what  one  might  see  in  Germany,  but  never- 
theless very  good.  Medical  science  has  here 
a  high  place.  There  are  as  many  research 
laboratories,  proportionately,  perhaps  more, 
than  in  Germany.  And  Scandinavia  has 
surely  given  more  than  her  proportionate 
share   of   research   work  to   medical   science. 


VI. 

ST.    PETERSBURG FEATURES   OF   THP:   RUSSIAN 

CAPITAL ITS  HOSPITALS. 

Fro:m  a  medical  point  of  view  our  visit  to 
St.  Petersburg  is  scarcely  worth  the  writing, 
for  we  saw  little  that  was  medical.  However, 
we  will  mention  the  journey  if  only  to  pre- 
vent others  from  going  the  same  way,  for 
personally  Russia  did  not  appeal  to  us.  The 
sail  from  Stockholm  to  St.  Petersburg,  how- 
ever, is  beautiful  and  is  perhaps  worth  the 
trouble  and  discomfort  of  the  days  spent 
under  the  shadow  of  the  Czar.  We  took 
passage  in  a  dinky  little  boat,  not  so  large  as 
many  of  the  Mississippi  River  boats,  for  our 
trip  across  the  Baltic.  There  were  quite  a 
number  of  passengers  on  board,  and  we  felt 
that  if  we  w^ere  foolish  in  going  to  Russia  (as 
everybody  in  Stockholm  told  us  we  were)  we 
had  lots  of  company.  Imagine  our  feelings, 
then,  when  on  getting  to  Helsingfors,  every- 
body save  ourselves  left  the  boat.  We  were 
the  only  passengers  for  St.  Petersburg.  But, 
as  I  said,  the  sail  is  beautiful.  First  the 
picturesque  coast  of  Sweden;  then  all  day 
long   through   the   thousands   of   islands   that 

59 


MEDICAL  EUROPE 

dot  the  Baltic  and  are  a  part  of  Finland; 
and,  finally,  the  magnificent  and  imposing 
approach  to  the  heart  of  St.  Petersburg  itself, 
past  the  frowning  forts  of  Kronstadt  and  the 
big  Russian  battleships. 

It  was  surprisingly  hot  for  May,  and  we 
sweltered  on  the  deck  while  at  least  two  dozen 
uniformed  and  bemedalled  ofiicials  examined, 


Russian  Droschke 


signed,  sealed,  and  countersigned  our  pass- 
ports, and  finally  allowed  us  to  leave  the  boat 
and  be  driven  to  a  hotel. 

The  Russian  droschke  (cab)  is  much  smaller 
than  its  name  (Isivoschtschik)  would  imply, 
and  the  horses  are  smaller  still,  but  tougher 
than  wire  nails — and  they  go  at  a  great  speed. 
The  drivers,  however,  make  up  in  size  for 
the  smallness  of  the  rest  of  the  outfit,  and  in 

CO 


ST.  PETERSBURG 

their  padded  kimonos  with  a  rear  ])readth  of 
something  hke  two  metres  somewhat  obscure 
the  view  ahead. 

St.  Petersburg  itself  is  a  city  worth  seeing. 
The  Nevskoi  Prospekt  is  a  wonderful  street. 
I  know  of  no  other  with  which  it  may  be 
compared.  There  are  beautiful  buildings 
along  the  Neva.  The  city  is  crowded  with 
splendid  churches  and  immense  palaces;  and 
in  the  Hermitage  is  one  of  the  finest  col- 
lections of  paintings  in  the  world.  There 
are  fine  parks  and  theatres  and  comfortable 
hotels  in  abundance.  But  despite  it  all  there 
is  an  odd  feeling  of  oppression  that  strikes  one 
the  moment  he  lands  on  Russian  soil,  and 
one  doesn't  breathe  freely  till  he  is  out  of  it 
all.  Perhaps  this  passes  away  after  a  time; 
I  should  certainly  hope  so  if  I  had  to  spend 
many  days  in  Russia. 

St.  Petersburg  is  expensive.  The  prices 
are  just  about  three  times  what  they  are  in 
Scandinavia;  a  ruble  (53  cents)  does  not  go 
as  far  in  St.  Petersburg  as  a  mark  (24  cents) 
goes  in  Berlin.  At  the  Hotel  de  I'Europe  a 
man  told  me  he  had  to  pay  a  ruble  for  a 
Scotch  high-ball.  If  that  isn't  a  good  tem- 
perance argument  I  don't  know  what  is,  and 
yet  we  saw  more  drunken  people  in  the 
streets  of  St.  Petersburg  in  three  days  than 

61 


MEDICAL  EUROPE 

I  have  seen  in  all  Europe  together  in  two 
summers'  travel. 

Vodka  (a  contemptuous  diminutive  of  voda, 
"water,")  the  national  drink,  is  a  grain 
whiskey,  pale,  white.  It  is  a  little  less  burn- 
ing than  raw  alcohol.  Russians  do  not  drink 
it,  they  gulp  it  down.  They  do  not  drink 
often;  they  cannot  afford  to;  but  when  they 
do  drink  they  get  drunk.  If  you  strike  a 
small  town  on  a  holiday  you  find  everybody 
in  that  town  drunk.  Desire  for  alcohol  is  a 
natural  taste,  and  everyone  takes  all  there 
is  to  be  had  when  the  opportunity  offers. 
That  is  all  there  is  to  it. 

The  streets  of  St.  Petersburg  are  fairly 
clean.  The  city  is  very  well  managed  from  a 
sanitary  standpoint.  It  cannot  be  compared 
in  this  respect  to  most  of  the  other  large  Euro- 
pean cities,  but  is  better  than  some  of  our 
American  cities.  There  are  twenty-six  hos- 
pitals in  the  city,  and  several  separate  institu- 
tions in  addition  devoted  to  scientific  medicine 
and  research.  The  spirit  in  medicine  is 
essentially  German.  All  the  better  men,  in 
addition  to  their  five  years'  university  course 
and  hospital  service,  go  to  Germany  to  finish 
their  medical  education. 

One  can  take  for  a  fair  example  of  the 
average  hospital  here  the  Marien.     We  visited 

G2 


ST.  PETERSBURG 

it,  especially  as  it  is  one  of  the  hospitals  solely 
for  the  poor.  The  patients  in  this  institution 
pay  nothing  wliatever.  The  buildings  are 
somewhat  old,  but  spacious  and  well  venti- 
lated. There  is  a  central  building  (in  which, 
as  is  always  the  case,  there  is  a  chapel)  and 
two  long  wings  on  either  side.  There  is  a 
large  well-kept  court  in  the  centre,  rich  in 
shade,  in  which  the  convalescents  may  wander. 
There  is  a  large  laboratory  building  for  both 
clinical  microscopy  and  gross  pathology  with 
autopsy-room  and  museum. 

Seeing  a  Russian  hospital  is  attended  w4th 
some  formality.  We  made  the  arrangements 
for  our  visit  with  the  head  nurse,  who  spoke 
English,  and  who  told  us  to  come  the  follow- 
ing day  at  eleven  o'clock  and  all  would  be 
prepared  for  us.  The  next  day  happened  to 
be  the  Czar's  birthday  and  we  were  somewhat 
embarrassed  by  the  remarkable  uniforms  that 
we  found  the  attendants  w^earing  when  we 
reached  the  hospital.  The  door-keeper,  for 
instance,  was  clothed  in  a  heavy  robe  of  yel- 
low and  red,  which  was  adorned  with  rows 
of  black  double-eagles  running  from  his 
shoulders  to  his  feet.  When  w^e  followed 
him  to  the  waiting-room  we  were  very  careful 
not  to  step  on  the  train  of  the  gown. 

After  we  got  by  the  first  stages,  however, 

63 


MEDICAL  EUROPE 

and  finally  met  the  real  medical  men,  we 
began  to  feel  at  home.  We  were  taken  from 
one  department  to  another,  and  in  each  found 
the  chief  of  the  service  awaiting  us.  All  these 
men  spoke  German,  but  none  of  them  that 
we  met  knew  English.  A  detailed  account 
of  the  visit  is  hardly  necessary.  Everything 
was  essentially  the  same  as  in  American  or 
German  hospitals.  The  patients  were  all 
clean,  the  beds  were  clean,  the  nurses  were 
immaculate.  In  the  gynaecological  wards, 
which  we  first  visited,  we  saw  over  the  beds 
(here  the  diagnoses  are  written  in  Latin  script) 
the  words,  "Endometritis,"  " Myoma  uteri," 
" Salpingitis,"  and  so  on.  We  did  not  see  any 
operations  but  the  operating-rooms  were  ade- 
quate and  apparently  aseptic.  In  every  ward 
there  were  two  separate  operating-rooms;  one 
for  septic,  and  one  for  non-septic  cases. 

The  nerve  clinic  interested  us  considerably. 
It  was  remarkably  well  equipped.  In  addi- 
tion to  the  ordinary  electric,  massage,  and 
Rontgen-light  apparatus,  there  was  a  large 
room  for  hydrotherapy.  For  the  hose  douche, 
there  were  installed  engines  in  the  basement 
which  insured  constant  pressure  of  any  de- 
sired degree.  The  neurologist  (his  card  is  in 
Russian  and  I'm  sure  the  reader  works  hard 
enough  as  it  is  without  having  to  translate  it) 

G4 


ST.  PETERSBURG 


told  us  that  one  hose  douche 
was  enough  in  a  case  of  hysteria. 
After  I  saw  the  stream  turned 
on  I  beheved  him.  The  only 
thing  I  ever  saw  that  compared 
with  it  in  force  was  the  stream  / 
from  the  nozzle  of  one  of  the 
New  York  fire-boat  hoses  that  is  arranged  to 
hit  the  roof  of  a  twenty-story  building.  No 
wonder  the  Russians  hate  to  bathe  if  their 
idea  of  a  bath  is  conceived  from  this  appa- 
ratus. One  bath  would  be  water  enough  for 
a  lifetime.  Seriously,  though,  there  were 
ample  bathing  facilities  in  all  the  wards.  The 
bath-tubs  were  large,  with  an  ample  supply 
of  both  hot  and  cold  water  and  with  inlet 
and  outlet  pipes  of  large  diameter,  so  that 
no  time  need  be  wasted  in  filling  and  emp- 
tying the  tubs. 

We  saw  also  in  this  depart- 
ment a  patient  treated  for  tri- 
facial neuralgia  by  means  of 
the  Rontgen  ray.  Such  treat- 
ment was  new  to  us,  but  we 
were  assured  that  the  idea 
was  ^' aus  Ameriha.^' 

In  the  pathological  labora- 
tory I  felt  more  at  home  than  in  any  place  I 
have  been  since  I  left  the  States,  for  hardly 

5  65 


MEDICAL  EUROPE 

had  I  entered  when  I  noted  two  or  three  Uttle 
laboratory  stunts  in  use  that  I  happened  to 
know  originated  in  the  laboratory  in  which 
I  used  to  work  at  home. 

"Where  did  you  get  this  idea?"  I  asked 
Dr.  Schueninoff,  who  is  chief  of  the  labora- 
tory, pointing  to  some  material  that  was  in 
process  of  preparation.  *'I  got  that  from 
Chiari,"  he  answered,  *'when  I  worked  in 
Prague,  and  Chiari  got  it  from  Mallory  when 
Mallory  worked  in  Prague."  Surely  the 
pathological  world  is  small! 

There  are  about  four  hundred  beds  in  this 
hospital,  and  yet  Dr.  Schueninoff  averages  six 
hundred  autopsies  a  year.  If  a  man  wanted 
lots  of  pathological  material  I  know  of  no 
better  place  in  Europe  to  get  it  than  right  here. 
He  would  be  welcome,  and  could  do  as  much 
as  he  wished.  He  could  have  a  seat  in  a  large, 
well-lighted  laboratory,  with  the  autopsy-room 
at  his  elbow.  He  would  find  better  technics 
practiced  than  in  most  German  laboratories. 
But,  sadly,  he  would  have  to  live  in  Russia. 
Personally  I  wouldn't  mind  foregoing  health, 
friends,  and  money,  to  fame;  but  if  it  came 
to  a  question  of  living  in  Russia,  I  would 
choose  to  die  unknown. 

However,  we  know  in  a  general  sort  of  way 
that   much   that   is    new   in    medical    science 

66 


ST.  PETERSBURG 

comes  out  of  Russia.  We  are  familiar  with 
the  recent  work  of  Pawlow,  and  there  is 
scarcely  a  physician  in  practice  to-day  who 
hasn't  tried  Kernig's  sign  in  meningitis. 
Perhaps  all  physicians  are  not  aware,  how- 
ever, that  Kernio;  is  a  St.  Petersburg  clinician. 


Pawlow 


There  has  been  no  greater  name  in  chemistry 
than  that  of  Mendelieff.  Perhaps  it  is  true, 
as  has  been  suggested,  that  cut  off  from 
political  activity,  the  energetic  minds  of  this 
great  empire  devote  themselves  with  especial 
vigor  to  science  and  particularly  to  medicine. 
It    is    stated    that    a    more    perfect    medical 

67 


MEDICAL  EUROPE 

faculty  exists  In  Russia  than  is  to  be  found  in 
Vienna  or  Berlin.  This  may  account  for  the 
high  standing  of  the  average  practitioner  in 
this  country. 

Here  in  Russia  there  is  no  fee  for  medical 
treatment.  Nobody  ever  asks  a  physician  for 
the  amount  of  his  bill.  It  is  universally  under- 
stood that  a  gentleman  pays  his  physician  a 
fair  sum — such  a  sum  as  he  can  afford  to  pay 
within  the  limits  of  his  income  and  his  sense 
of  generosity.  The  Russian  mind  cannot  con- 
ceive how  a  man  engaged  in  the  holy  pursuit 
of  saving  life  and  alleviating  suffering  can 
put  a  price  on  his  services.  This  custom  of 
generosity  in  giving  service  and  trusting  to  a 
like  generosity  in  receiving  reward  for  the 
same  is  a  beautiful  one,  and  cuts  out  from 
medicine  what  William  James  would  call 
*'the  Trades  Union  Wing  of  the  profession." 

The  Russian  country  through  wdiich  we 
travelled  on  our  way  to  the  German  border 
was  not  without  interest.  We  were  met 
everywhere  by  children  begging  for  coppers. 
These  children  were  the  best  natural  actors 
I  have  ever  seen.  A  ragged  urchin  who  ap- 
proached me  had  the  faculty  of  filling  his 
eyes  with  tears  at  will.  It  was  wonderful  to 
watch  his  changing  expression;  the  cunning 
gleam    that    he  sized  you  up  with,  the  tear- 

68 


ST.  PETERSBURG 

stained  face  of  appeal,  and  the  grin  of  satis- 
faction with  which  he  departed  after  he  had 
grafted  you  for  all  your  loose  kopecks. 

Another  thing  that  surprises  the  traveller 
here  in  Russia  is  the  large  number  of  small 
hospitals  scattered  throughout  the  country. 
There  is  scarcely  a  town  of  any  size  whatever 


Pir-^iAN   I'la-am- 


but  has  its  hospital.  Certainly  we  would  not 
look  for  hospitals  in  towns  several  times  the 
size  in  America.  The  little  liospitals  are 
situated  on  the  edge  of  the  town,  usually 
where  there  is  plenty  of  open  space  and  shade. 
The  buildings  are  of  brick  and  are  one  story 
high.  Trained  nurses  in  uniforms  and  young 
physicians  in  white  duck  are  in  charge. 
Everything   about  these   hospitals   is   scrupu- 

69 


MEDICAL  EUROPE 

lously  clean.  There  is  no  dirty  bed-linen,  no 
disagreeable  odors,  no  unclean  wood-work. 
Each  of  these  hospitals  has  an  adequate 
laboratory  and  surgical  equipment. 

All  of  this  is  far  removed  from  what  we 
would  naturally  expect  to  find  in  this  con- 
tradictory country,  but  a  reason  for  these 
hospitals  may  be  sought  in  the  desire  of  the 
zemstvos  to  lessen  the  economic  plague  incident 
to  the  ravages  made  by  disease  and  epidemics 
on  the  poorly-fed  and  badly-housed  peasants. 
The  zemstvo,  or  territorial  assembly,  by  the 
way,  is  a  body  composed  of  representatives 
of  all  classes  which  takes  the  place  of  the  old 
nobility  assemblies  and  concerts  measures  for 
the  common  good  of  the  people. 

The  shortness  of  the  life  average  (half  the 
children  born  in  Russia  die  before  reaching 
the  fifth  year)  makes  the  unproductive  age  out 
of  all  proportion  to  the  productive  age,  which 
is  a  bad  thing  economically  for   any  nation. 

The  zemstvos  have  done  everything  they 
could  naturally  to  decrease  this  mortality,  but 
their  lack  of  funds  makes  it  difiicult  for  them 
to  secure  first-class  medical  men.  I  was  told 
that  the  pay  of  these  physicians  was  not  more 
than  400  or  600  rubles  a  year  (200  to  300 
dollars)  and  one  can't  drink  Scotch  high- 
balls on  that  salary  in  Russia. 

70 


ST.  PETERSBURG 

I  was  also  told  that  lack  of  money  was  not 
the  only  thing  the  zemstvos  had  to  contend 
with.  There  was  really  an  insufficiency  of 
medical  men  for  its  needs.  At  the  time  of 
the  death  of  Alexander  11  there  were  only 
3000  medical  students  in  Russia,  and  of  these 
only  about  300  graduated  each  year.  Think 
of  this  for  140,000,000  people,  and  compare 
it  with  our  medical  (and  so-called  medical) 
fledglings  that  are  turned  loose  on  the  com- 
munity each  year.  Is  it  any  wonder  that  so 
many  young  Hebrews,  who  are  quick  to  see 
a  good  opening,  are  going  into  medicine  each 
year,  and  are  crowding  the  German  universi- 
ties, when  they  can  go  cheaply,  to  overflowing. 

Not  only  men  but  a  great  many  women  are 
going  into  medicine  here  in  Russia  nowadays. 
For  some  reasons  they  are  considered  superior 
to  the  men.  They  do  more,  and  they  live  on 
less.  They  have  a  way  of  overcoming  the 
old  medical  superstitions  and  insinuating 
hygienic  ideas. 

The  zemstvos  themselves  have  founded 
modest  schools,  in  addition  to  the  Govern- 
ment female  medical  annexes,  for  the  educa- 
tion of  women  physicians  and  surgeons.  So 
that  now  these  women,  who  seem  to  possess 
a  real  longing  to  be  of  use  to  the  people,  will 
find  ample  scope  for  their  noble  passion. 

71 


MEDICAL  EUROPE 

We  did  not  leave  Russia  without  investi- 
gating the  food  question.  We  tried  every- 
thing, and  at  times  "got  stung."  But  in 
general  Russian  food  is  the  real  thing.  One 
has  never  drunk  tea  till  one  has  tried  it  in 
Russia,  and  the  caviare  as  one  gets  it  here  is 
something  to  live  for.  Caviare  is  the  one 
thing  in  St.  Petersburg  that  is  comparatively 


Monument  to  Pf.tkr  the  Great 

cheap,  and  we  nearly  ruined  our  gastric 
mucosa  with  it  in  trying  to  get  square  for 
other  deals.  There  is  an  interesting  restau- 
rant here,  where  one  is  given  a  net  and  is 
allowed  to  scoop  up  from  a  big  tank  in  the 
centre  of  the  room  the  fish  he  desires  to  be 
served  with.  As  St.  Petersburg  is  a  winter 
city,  we  did  not  see  it  at  its  best,  when  it  is 
filled  with  the  gayest  society  in  all  Europe. 
But  it  is  away  from  St.  Petersburg  after  a 

72 


ST.  PETERSBURG 

hard  clay's  travel  one  really  enjoys  the  food. 
The  national  dish  of  Russia  is  cabbage  soup. 
It  is  made  of  sour  cabbage  and  water  (empty 
^'  shtshV).  With  fresh  fat  beef  and  clotted 
cream  added  (smietciJia)  it  is  a  dish  for  kings. 
A  bowl  of  this  soup,  a  dish  of  buckwheat, 
baked  porridge,  and  a  pot  of  tea  from  the 
smoking  samovar,  which  is  found  in  every 
household  in  Russia  from  Tsar  to  mujik,  is 
better  than  all  the  dinners  the  big  hotels  of 
the  cities  can  supply. 


VII. 

BERLIN ANGLO-AMERICAN    MEDICAL    ASSOCIA- 
TION  TYPES  OF  AMERICAN  STUDENT. 

The  Friedrichstrasse  Bahnhof  is  in  the 
centre  of  Berlin.  On  one  side  of  it  is  the 
Central  Hotel,  and  in  the  Central  Hotel  is 
the  Restaurant  Heidelburger.  A  man  at  the 
door,  clothed  in  a  brown  uniform,  touches 
his  cap  to  you  and  says,  "Mahlzeit, "  as  you 
enter.  You  pass  through  a  number  of  rooms 
filled  with  tables  at  which  sit  the  types  of  men 
and  women  that  will  soon  become  familiar 
to  you,  and  you  glance  enviously  at  the  tall 
steins  of  Muenchener  and  Pilsener  and  the 
plates  of  wurst  and  cotelette  and  schnitzel. 
Then  you  lose  your  way,  and  you  say  some- 
thing to  a  waiter  who  doesn't  understand 
your  speech  but  who  smiles  and  pilots  you 
to  a  stairway;  you  ascend  and  enter  a  big 
room  and  presto — you  are  no  longer  in  Ger- 
many (except  for  the  steins),  for  here  is 
English  speech  and  familiarly  cut  clothes  and 
smooth  faces  and  the  radiance  of  good  cheer 
that  can  come  only  from  a  group  of  fellow- 
countrymen,  far  from  home,  who  are  united  by 
the  firm  band  of  fellowship  in  medical  study. 

74 


w 


BERLIN 

This  is  the  Anglo-American  Medical  Asso- 
ciation of  Berlin,  a  society  organized  in  1903 
by  Dr.  J.  H.  Honan,  of  Berlin,  for  the  pur- 
pose of  promoting  the  interests  of  Anglo- 
Americans  seeking  courses  in  medicine  in 
Berlin. 

It  is  needless  to  say  that  Berlin  is  a  big  city; 
that  its  customs  are  not  our  customs;  that  its 
clinics  and  laboratories  are  not  all  in  one 
place;  and  that  a  man,  coming  to  Berlin  for 
the  first  time,  with  no  definite  knowledge  as 
to  just  what  men  or  what  courses  he  wants, 
can  waste  many  valuable  days,  or  weeks,  in 
getting  settled  down  to  his  work.  It  is  the 
idea  of  the  Society  to  obviate  this  waste  of 
time  as  much  as  possible  by  giving  the  new- 
comer a  clear  idea  of  the  various  courses 
given,  both  privately  and  by  the  university; 
the  cost,  value,  duration,  and  time  of  com- 
mencement of  the  same;  to  tell  him  what  to 
avoid  (for  there  are  courses  to  be  avoided, 
even  in  Berlin),  and  to  extend  the  hand  of 
good  fellowship  to  the  lonesome.  Moreover 
one  hears  here  on  each  Saturday  night  (which 
is  the  meeting  time  of  the  Society)  an  informal 
talk  by  some  one  of  the  great  medical  men  of 
Berlin.  For  the  above  enumerated  privileges 
the  new-comer  pays  the  sum  of  two  marks, 
which  makes  him  a  perpetual  member  of  the 

77 


MEDICAL  EUROPE 

Society  and  entitles  liim  to  an  annual  report, 
which  is  sent  to  his  home  address. 

There  are,  on  an  average,  about  thirty  men 
present  at  these  Saturday  night  gatherings. 
It  is  estimated  that  there  are  always  present 
in  Berlin  from  forty  to  seventy  Americans 
who  are  here  for  the  purpose  of  studying 
medicine.  The  average  duration  of  stay  is 
three  to  four  months.  Of  course  many  men 
come  for  a  year  or  two  years'  work  here,  but 
the  number  of  practising  physicians  who  have 
only  a  month  or  two  of  vacation  that  they 
wish  to  spend  in  study,  cuts  the  average  down. 
So  it  is  that  the  faces  at  the  club  are  constantly 
changing.  But  one  man  goes  on  forever,  and 
that  is  the  worthy  president,  Dr.  J.  H.  Honan. 

It  is  largely  due  to  the  efforts  of  Dr.  Honan 
that  the  club  is  the  success  it  is.  He  is  an 
American,  a  former  resident  of  Chicago,  and 
at  present  permanently  located  in  Berlin  with 
a  large  American  practice.  It  is  rare  indeed 
to  visit  the  club  on  a  Saturday  night  and  not 
see  Dr.  Honan's  face  at  the  head  of  the  table. 
Even  if  you  have  returned  to  Berlin  for  a 
second  time,  the  club  is  as  if  you  left  it  yester- 
day, for  Dr.  Honan,  and  his  bell  with  which 
he  calls  you  to  order,  are  just  as  you  left  them 
years  before. 

The  Doctor  is  a  large,  well  built  man,  with 

78 


BERLIN 

luxuriant  black  whiskers.  He  wears  always 
a  frock  coat,  white  waistcoat  and  tall  hat.  He 
has  a  full,  deep,  resounding  voice,  and  when 
he  rises  and  says,  "The  society  is  especially 
honored  to-night"  (he  never  forgets  to  em- 
phasize the  "especially")  "by  the  presence  of 
the  world-renowned  Geheimrath-Professor  So- 
and-so,  who  will  speak  to  us  on  that  subject 
with  which  his  name  is  everywhere  associated 
in  the  medical  world,  etc.,"  we  all  stand  up 
and  cheer  and  are  quite  sure  that  we  are 
getting  (as  a  chap  from  Green  Bay,  Wisconsin, 
expressed  it)  "the  right  kind  of  dope." 

And  then  when  the  Geheimrath-Professor 
So-and-so  has  concluded  his  remarks,  and,  in 
accordance  with  a  motion  of  thanks  feebly 
offered  by  some  humble  member  in  the  back 
of  the  room,  Dr.  Honan  rises  and  announces, 
"It  is  moved,  and  seconded,  that  the  Anglo- 
i.\merican  Medical  Association  of  Berlin  does 
hereby  most  emphatically  and  unanimously 
extend  its  cordial  and  sincere  thanks  for  the 
exceedingly  interesting  and  instructive  lecture 
which  we  have  had  the  honor  and  pleasure 
of  listening  to  to-night,"  we  all  rise  and  bow, 
and  the  G.-R.-Professor  bows,  and  we  ap- 
plaud a  whole  lot  more,  and  finally  sit  down, 
feeling  that  the  U.  S.  A.  can  surely  do  the 
proper  thing  at  the  proper  time. 

79 


MEDICAL  EUROPE 

No  one  can  know  Dr.  Honan  without  feel- 
ing that  he  has  met  a  real  man;  an  earnest, 
enthusiastic,  unselfish,  whole-souled  lover  of 
medicine  and  medical  education  in  its  best 
and  broadest  sense. 

It  is  not  every  man  who,  for  no  compensa- 
tion save  the  knowledge  that  he  is  helping  his 
fellow  men,  would  devote  the  time  and  energy 
to  such  a  thankless  task  as  has  Dr.  Honan. 
For  remember,  the  men  that  constitute  the 
club  come  and  go.  They  get  only  a  thin  cross- 
section  of  the  structure  that  Dr.  Honan  has 
built  and  which  needs  constant  attention  to 
keep  from  crumbling.  Only  a  few  stay  long 
enough  to  appreciate  and  to  thank  him  for 
the  work  he  is  doing. 

And  the  officers  of  the  Society  are  also 
deserving  of  much  praise.  No  one  except  a 
man  who  has  been  associated  with  the  club 
in  an  official  capacity  realizes  how  many 
evenings  are  spent  in  looking  up  courses  and 
writing  letters  and  making  up  sections  for 
the  many  men  who  are  constantly  writing  to 
the  club  for  help.  But  these  men  all  do  their 
work  cheerfully,  and  I  hope  they  will  know 
that  one  American  at  least  appreciates  all 
that  they  have  done  to  make  Berlin  the  best 
city  in  the  world  for  an  American  student. 

There  is  always  a  formal  business  meeting 

80 


BERLIX 

after  one  of  these  Saturday  lectures,  which 
inchides  such  reports  as  those  of  the  Orlen- 
tieren,  Program,  and  Library  committees,  the 
announcement  of  new  courses,  and  what  not. 
I  had  nearly  forgotten  to  state  that  the  two 
mai'ks'  membership  fee  includes  the  use  of 
the  reading-room  and  library.     The  latter  is 


At  the  next  regular  weekly  meeting  of  the 


Anglo-American  Medical  Association  of  Berlin 

(/ 

at  the  Restaurant  Heiddberger,  Saturday  ev^fning^,.-)t^^t^i:^^^.7i^ 

at  7,30  o'clock (^-^^^    xfe 

will  address  us.  Subject_4=.Zl^Z^ 


Secretary 


at  Rothacker's  book-store,  Friedrichstrasse 
lOoB.  Here  are  to  be  found  a  very  good  list 
of  English,  French,  and  German  journals, 
which  have  been  donated  to  the  Society  by 
the  publishers.  Stationary  is  also  furnished 
gratis,  and  is  of  that  peculiarly  arranged 
German  variety  that  weighs  exactly  one-half 
ounce  for  two  sheets  and  the  envelope,  so 
that  the  added  moisture  of  sealing  the  letter 
enables  the  post-office  officials  to  charge  up 


MEDICAL  EUROPE 

ten  cents  overweight  for  the  people  at  home 
to  pay. 

The  lecturer  of  the  evening  speaks  nearly 
always  in  German.  Unfortunately  the  ma- 
jority of  the  club  are  somewhat  short  on 
German.  They  have  the  privilege  of  seeing  a 
great  man  but  they  carry  away  little  of  what  he 
says.  One  man  who  sat  attentively  through  a 
meeting,  after  listening  to  an  hour's  lecture 
by  Dr.  Bruel,  turned  to  me  and  said,  "Well, 
I  got  one  word  out  of  that — Tuherkulose!^^ 

The  experiences  of  the  men,  as  related  over 
the  beer  when  the  meetings  are  officially  over, 
are  always  of  interest.  They  are  as  varied  as 
are  the  types  of  Americans  one  sees  here 
themselves.  "  This  is  a  bum  town, "  says  some 
fellow  from  the  backwoods  of  the  good  old 
U.  S.  A.,  who  has  come  over  with  the  expec- 
tation of  helping  some  prominent  surgeon  do 
laparotomies  during  a  three  weeks'  sojourn; 
''I've  been  here  darned  near  my  time  limit 
now  and  I  haven't  been  near  enough  to  an 
operation  to  see  it  through  an  opera-glass." 
Another  says,  "What's  the  use  going  to  these 
blooming  clinics  when  you  can't  tell  what  the 
fellow^  is  talking  about  .^  I  should  think  they 
would  learn  to  speak  English." 

I  actually  met  a  fellow  here  once  who  had 
by  mistake  got  into  a  course  in  gross  path- 

82 


BERLIN 

ology  (I  haven't  the  least  idea  what  he  thought 
he  was  getting).  He  watched  the  instructor 
nervously  for  a  while,  doing  a  rather  difficult 
dissection  of  the  thoracic  duct  in  a  case  of 
miliary  tuberculosis,  and  then  dug  his  elbow 
into  my  ribs  and  said,  "Say,  what's  he  wast- 
ing so  much  time  on  that  woman  for?  She's 
dead,  isn't  she?" 

There  are  also  men  like  a  tall  Westerner 
who  stalked  into  Bier's  operating-room  one 
day,  pushing  aside  nurses  and  assistants, 
and  who  having  reached  the  centre  of  the 
room  stopped,  looked  around  and  said  in 
a  loud  tone  of  voice:  "Sav,  I  want  to  see 
Hyper^emia." 

But  all  Americans  (Goff  sei  danlx)  are  not 
like  the  above,  and  the  Germans  know  it 
and  appreciate  it.  There  are  always  a  good 
lot  of  clean,  eager,  industrious,  brilliant 
workers  here  from  our  country,  and  some  of 
them  have  turned  out  pieces  of  research  from 
the  Berlin  laboratories  of  which  the  chiefs 
are  proud.  There  is  always  a  chance  here 
for  such  men  to  get  any  and  all  kinds  of 
work;  as  well  as  intimate  association  with 
the  leaders  of  German  surgery,  clinical  and 
scientific  medicine. 

To  show  the  value  of  the  Society,  aside 
from  its  other  good  work  the  following  list 

85 


MEDICAL  EUROPE 

of    speakers    for    the    Winter    of    '06-'07    is 
appended : 

September  29,  1906.  Address  by  the  Presi- 
dent on  development  of  the  Association, 
followed  by  social  evening. 

October  6,  1906.  Prof.  Dr.  Stoeckel— Some 
New  Gynaecological  Operative  Methods  of 
Treatment. 

October  13,  1906.  Dr.  Paul  Cohnheim— 
Chronic  Intestinal   Catarrh. 

October  20,  1906.  Prof.  Moeller— The  Early 
Treatment  of  Phthisis. 

October  27,  1906.  Prof.  Max  Henkel— 
Therapy  of  Myomata  of  the  Uterus. 

November  3,  1906.  Dr.  Knorr — Cystoscopy 
and  Catheterization  of  Ureters. 

November  24,  1906.  Dr.  P.  Cassirer — Path- 
ology and  Treatment  of  Tabes  Dorsalis. 

December  1,  1906.  Dr.  Thumin — Purpose 
of  Cystoscopy  in  the  Female. 

December  8,  1906.  Prof.  Dr.  Diihrssen — 
Vaginal  Hysterectomy. 

December  15,  1906.  Geh.-Rat  Prof.  Dr. 
Miller — Bacteria  of  the  Mouth  and  their 
Relation  to  Internal  Diseases. 

December  22,  1906.  Prof.  Dr.  Krause—The 
Status  of  Present-Day  Surgery  of  the 
Brain. 

86 


BERLIN 

January  5,  1907.  Geh.-Rat  Prof.  Dr.  Brieger 
- — Hydrotherapeutics  and  Other  Methods 
of  Treatment. 

January  U,  1907.  Dr.  C.  S.  Engel— Normal 
and  Pathological  Appearances  of  the  Blood. 

January  19,  1907.  Prof.  Dr.  Rosenheim — 
Colitis. 

February  2,  1907.  Geh.-Rat  Prof.  Dr.  Hoffa 
— Chronic  Joint  Rheumatism  and  Arthritis 
Deformans. 

February  9,  1907.  Dr.  Frank — Sexual  Neu- 
rasthenia following  Gonorrhoea. 

February  16,  1907.  Prof.  Dr.  Baginsky — 
Tubercular  and  Simple  Forms  of  Cerebro- 
spinal Meningitis. 

February  22,  1907.  Dr.  Ritter— Surgery  of 
the  Frontal  Sinuses. 

March  2,  1907.  Prof.  Dr.  Koblanck— Car- 
cinoma of  the  Uterus;  Differential  Diagno- 
sis and  Treatment. 

March  9,  1907.  Dr.  Edw.  Saalfeld^Treat- 
ment  of  Skin  Diseases  with  X-Ray. 

March  16,  1907.  Prof.  Dr.  Nagel— Diag- 
nostic Significance  of  Haemorrhage  from  the 
Female    Genitalia. 

March  23,  1907.  Dr.  Paul  Cohnheim— 
Hyperchlorhydria  of  the  Stomach. 

March  30,  1907.  Dr.  Langstein— Infant 
Feeding. 

87 


MEDICAL  EUROPE 

April  6,  1907.  Prof.  Dr.  Schleich^Tlieory 
of  Pain,  and  Latest  Development  in  Local 
and  General  Anaesthesia. 

April  13,  1907.  Dr.  Karewski — Debatable 
Points   on   Anaesthesia. 

April  20,  1907.  Dr.  Westenhoeffer— What  to 
do  with  the  Lung  in  Tuberculosis. 

April  27,  1907.  Prof.  Dr.  Grawitz— Value  of 
Blood  Examination  to  the  Practitioner. 

May  4,  1907.  Geh.-Rat  Prof.  Dr.  Bumm— 
Gonorrhoea  and  Marriage. 

May  11, 1907.  Prof.  Dr.  Hildebrandt— Tuber- 
culosis of  the  Joints  and  its  Treatment. 

May  25,  1907.  Dr.  Albu^Differential  Diag- 
nosis of  Chronic  Cholelithiasis. 

June  1,  1907.  Dr.  Oestreich— The  Position 
of  the  Stomach. 

June  8,  1907.  Prof.  Dr.  Borchardt^Cere- 
bellar  Surgery. 

June  15,  1907.  Dr.  Joseph— The  Latest 
Facts  About  Syphilis. 

June  22,  1907.  Dr.  Fleishman  —  Serum 
Therapy. 

June  29,  1907.  Dr.  Ludwig  Pick— Some 
Facts  About  Tumors. 

July  6,  1907.  Prof.  Dr.  Blumenthal— Balneo- 
dietetic  Treatment  of  Kidney  Diseases. 

July  13,  1907.  Geh.  Prof.  Dr.  Senator— Lung 
Emphysema. 


BERLIN 

July  20,  1907.  Dr.  Fritz  Meyer— Progress 
in  Serum  Therapy. 

July  27,  1907.  Prof.  Dr.  Dietrich— Recent 
Researclies  in  Causes  of  Carcinoma. 

August  10,  1907.  Prof.  Dr.  Klemperer— 
Recent  Researches  in  Tuberculosis. 

August  17,  1907.  Dr.  Ernest  Fuld— Physi- 
ological  Chemistry. 


VIII. 

BERLIN    CONTINUED THE    WEST    END    VERSUS 

THE   LATIN   QUARTER THE  ROYAL   CHARITE 

HOSPITAL. 

Before  beginning  work,  it  is  of  course 
necessary  for  a  man  to  find  a  place  to  live, 
and  that  in  Berlin,  notwithstanding  the  thou- 
sands of  pensions  and  furnished  rooms,  is  not 
always  an  easy  matter.  Happy  is  he  who 
comes  provided  with  an  address  of  a  place  in 
which  some  of  his  friends  have  lived  and 
which  they  have  found  satisfactory.  It  is 
with  no  desire  to  advertise  the  following 
places  that  this  list  is  included  here,  but 
these  places  are  especially  recommended  by 
the  Anglo-American  Medical  Association  of 
Berlin : 

Near  the  Clinics  is  the  Pension  Kurzhall, 
Luisenstr.  67;  Pension  Jendritza,  Karlstr. 
31;  Pension  Kromat,  Charitestr.  9;  Pension 
Hoeven,  Charitestr.  3;  Furnished  Rooms, 
Albrechstr.  22. 

In  the  Resident  District  is  the  Pension 
Belmont  (American),  Victoria  Luise-Platz  10; 
Pension  Clare  (American),  Heilbronnerstr.  25, 
Miss  Hunt  (American),  Kleiststr.  11;  Pension 

90 


BERLIN 

von  ITeuckmann,  corner  WIclimann-  and 
Keithstr. ;  Pension  Frau  Prof.  Neumann, 
Kalkreuthstrasse  5;  Pension  Tschenschner, 
Kurfurstenstr.    112. 

The  Pension  Iloeven  at  Charitestr.  3,  I 
know  about  personally.  The  Hoevens  were 
for  many  years  at  Albrechstrasse  22,  which 
place  has  always  been  a  favorite  with  Ameri- 
can medical  men.  In  their  new  place  there 
are  four  bath-rooms  (just  think  of  that  in 
Berlin!)  and  they  are  not  used  for  storing 
coal  or  for  wash-tubs,  as  most  Berlin  bath- 
rooms are,  but  actually  supply  you  with  hot 
and  cold  water  every  hour  of  the  twenty- 
four.  And  besides  "Tilly"  is  there  to  mother 
you  and  to  see  that  there  are  no  holes  in 
your  socks.  There  are  many  of  us  who  will 
always  have  a  soft  spot  in  our  hearts  for 
-Tillchen." 

Roughly  speaking  there  are  two  parts  of 
the  city  where  medical  men  live.  They  either 
go  far  into  the  West  End,  or  else  camp  down 
in  the  so-called  Latin  Quarter,  at  the  doors 
of  the  principal  clinics.  The  West  End  is 
beautiful;  the  houses  are  roomy  and  well 
kept,  there  are  lots  of  fresh  air  and  flowers, 
and  everywhere  about  are  open-air  cafes 
and  gardens  where  one  can  hear  good  music 
as    one    drinks    his    evening   beer.     But    the 

01 


MEDICAL  EUROPE 

West  End  is  unhandy,  it  is  so  far  from  all 
the  clinics.  Street-car  service  in  Berlin  is 
adequate,  but  it  is  slow.  If  one  lives  near  the 
Zoological  Garden  he  can  get  to  Friedrich- 
strasse  quite  quickly  by  the  Stadtbahn,  but 
then  one  must  take  a  bus  or  a  car  to  get  to 
his  clinic.  When  I  lived  in  the  West  End  I 
figured    on    killing    an    hour    each   trip,    and 


Park  of  the  Ciiarite — Church  at  right 


frequently  I  was  longer  getting  to  my  work. 
The  expense  of  urban  travel  is,  however, 
very  little.  One  can  get  a  Stadtbahn  ticket 
good  for  as  many  rides  as  one  chooses  to  take 
from  the  first  of  one  month  to  the  first  of  the 
next,  for  three  marks  (72  cts.).  The  regular 
tariff  on  the  street  cars  is  a  little  less  than  half 
our  fare  (ten  pfennigs).  One  can  travel  quite 
a  distance  on  an  omnibus  for  five  pfennigs — 
a  fraction  over  one  cent. 

92 


BERLIN 

For  convenience  and  proximity  to  work  it 
is  perhaps  wiser  to  live  in  the  '^Lateiniscli 
Viertel,"  even  though  some  of  the  houses  be 
ohler  and  darker,  and — mayhap — more  noisy. 
No})ody  stays  in  the  house  in  the  evening 
here,  anyway — unless  it  is  some  weak-minded 
American  who  has  promised  to  write  Berlin 
letters  to  his  editor  at  home.  We  can  bound 
this  student  territory  rouglily  by  Invaliden- 
strasse  and  Dorotheenstrasse  on  the  north 
and  south  respectively,  and  extending  between 
Wilhelm  Ufer  and  Grosse  Hamburgerstrasse. 
Those  who  are  working  in  anatomy  or  in  the 
Charite  find  Luisen,  Philipp  and  Karl  streets 
convenient.  Lusienstrasse  is  also  handy  for 
those  who  are  attending  Bumm's  obstetrical 
clinic.  Olshausen's  clinic  is  on  Artillerie- 
strasse  (those  working  in  obstetrics  must  of 
course  be  near  their  work).  The  latter  street 
is  also  convenient  to  Ziegelstrasse,  where  one 
finds  Max  Joseph,  Bier,  and  Senator.  Here, 
also,  is  the  medical  library  in  the  Langen- 
beck  Haus,  in  which  one  can  read  by  getting 
permission  from  Prof.  Ewald. 

There  are  two  methods  of  living,  adopted 
I  should  say  in  about  equal  measure  by 
Americans,  i.e.,  full  pension,  or  furnished 
room  with  breakfast,  which  last  leaves  one 
free  to  eat  lunches  and  dinners  where  one  will. 

93 


MEDICAL  EUROPE 

In  the  West  End  one  Is  more  apt  to  live  en 
pension.  In  the  students'  quarter  it  is  better 
to  depend  on  the  various  restaurants,  which  are 
convenient  and  comparatively  inexpensive. 

What  does  it  cost  to  live  in  Berlin?  One 
cannot  answer  such  a  question,  any  more  than 
one  can  tell  you  what  it  costs  to  live  in  New 
York  or  Kalamazoo.  The  booklet  of  the  As- 
sociation tells  you  that  the  cost  of  living  in 
Berlin  is  the  same  as  in  New  York,  London, 
or  Paris.  It  costs  just  as  much  as  you  choose 
to  spend.  Perhaps  the  average  cost  of  full 
pension  (room,  meals,  and  service)  in  Berlin 
is  one  hundred  and  forty  marks  a  month 
(about  thirty-five  dollars).  A  lucky  man  may 
find  a  good  pension  for  a  hundred  marks.  It 
is  rare  that  one  pays  over  a  hundred  and  sixty 
marks. 

For  a  furnished  room  one  pays  from  twenty- 
five  to  fifty  marks.  The  difference  in  price 
does  not  depend  so  much  on  the  room  as  on 
whether  you  are  short  and  fat  and  blond 
with  a  stringy  Schnurbart  and  say:  '' Bitte, 
gnaedige  Frau,  Ich  wuenche  gem  ein  moe- 
hliertes  Zimmer  zu  bekomnien/'  or  are  tall  and 
lank  and  smooth-faced,  and  say,  ''Hahen  sie 
ein — ein — a  room  to  let.^"  This  price,  how- 
ever, includes  only  the  room  (unless  two  clean 
towels  a  week  and  a  change  of  sheets  monthly 

94 


BERLIN 


be    worth    mention).      Bedienung     (service), 

light,  heat  (and  anything  else),  are  all  extra. 

Americans  are  inclined  to  kick  at  these  extra 

charges.     For  such  people  there  are  always 

landladies    who    make    you    an    ''inclusive" 

price.     This  is 

usually  about  a 

third  more  than  it 

would  be  if   you 

did    the    extra 

arithmetic,  but  it 

pleases  the  afore- 

s  aid    average 

American  and  he 

assures   you   that  he  is 

not   getting    soaked    by 

extra    charges — even    if 

he  is  paying  double  what 

you    are    by    the    other 

method. 

Having  found  your 
room  and  locked  up 
your  patent  leather  shoes  (which  latter  you 
will  do  at  once  if  you  are  familiar  with  Ger- 
man shoe  polish),  it  is  well  to  take  a  turn 
about  and  see  what  Berlin  has  to  offer  in  the 
way  of  hospitals.  Naturally  one  begins  with 
the  Royal  Charite. 

The  Charite  is  by  no  means  a  model  hos- 

95 


MEDICAL  EUROPE 

pital.  It  impresses  one  as  an  uniiniform 
village — and  so  it  is,  a  collection  of  buildings 
of  various  form  and  varied  age,  with  no  par- 
ticular grouping,  scattered  here  and  there 
amid  trees  and  non-parallel  streets,  and  sepa- 
rated from  the  busy  whirl  of  Berlin,  in  one 
place  by  a  wall,  in  another  by  a  row  of  tene- 
ments,   in    still    another    by    the    yards    that 


Grounds  of  the  Charite 

buttress  the  Stadtbahn.  There  are  beautiful 
new  buildings  here,  notably  the  new  Patho- 
logical Institute,  which  has  for  its  equal  only 
one  other  such  building  in  the  world  and  that 
the  new  Rockefeller  Institute  for  Medical 
Research,  in  New  York.  There  are  also  here 
buildings  so  old  that  you  fear  lest  your  feet 
go  through  the  planking  as  you  walk  the 
wards,  and  the  smells  that  arise  on  a  hot  day 

9G 


Rudolph  Yirchow 


BERLIN 

make  you  wonder  if  they  were  ever  ventilated. 
But  it  is  these  same  old  buildings  that  call  the 
student  of  medical  history  first  to  the  Charite, 
for  here  was  made  much  of  the  German  medi- 
cine that  we  from  the  West  come  to  seek. 

Personally,  I  am  not  at  all  romantic,  but 
when  for  the  first  time  I  came  upon  the  old 
weather-beaten  building,  with  its  now  crumb- 
ling plaster-walls,  where  Rudolph  Virchow 
erected  the  frame-work  of  cellular  pathology 
for  all  scientific  medicine  to  build  upon,  I 
stood  for  a  full  hour  with  my  hat  in  my  hand, 
my  mind  struggling  to  grasp  the  secret  of  his 
achievements.  And  when  finally  I  came  back 
to  earth  I  had  no  desire  to  go  through  the 
new  Institute  across  the  way,  but  reserved 
that  visit  for  another  day  and  went  slowly 
homeward. 

The  foundation  of  the  Charite  dates  from 
the  year  1710.  The  cause  of  the  erection  of 
the  first  building  was  the  outbreak  of  the 
plague  in  Prussia,  in  1709,  but  the  plague 
spared  Berlin,  and  the  building  was  used  as 
a  poor-house  and  garrison  infirmary.  In  1726 
the  Royal  Charite  really  first  became  a  healing 
and  teaching  institution.  The  foundation  of 
the  University  caused  a  need  of  clinics  for 
medical  instruction  and  led  to  an  agreement 
between  the  University  and  the  Charite  where- 

99 


MEDICAL  EUROPE 

by  one  part  of  the  Charite  was  turned  into 
university  clinics.  The  names  of  the  men  who 
have  been  chiefs  of  chnics  in  the  Charite 
would  almost  be  a  list  of  the  men  who  have 
made  German  medicine  what  it  is  to-day. 
In  surgery  there  was  Johann  Rust  and 
Dieffenbach;  and  later  Adolf  Bardeleben 
(who   was   the    first    to    introduce    antiseptic 


Surgical  Clinic — Ciiartte 


surgery  into  Germany),  and  Franz  Koenig. 
The  first  director  of  the  medical  clinic  was 
Johann  Christian  Reil,  famous  as  a  fighter  for 
freedom  in  the  treatment  of  insanity.  Schoen- 
lein  was  one  of  the  first  to  introduce  micro- 
scopical and  chemical  methods  into  clinical 
diagnosis.  Theodor  Frerichs  is  known  for 
his  contributions  to  our  knowledge  of  dis- 
eases of  the  liver  and  kidneys,  and  diabetes. 

100 


BERLIN 

The  fame  of  Ludwig  Traube  brought  students 
to  BerHn  from  many  lands.  In  psychiatry 
and  nerve  diseases  there  have  been  such  men 
as  Griesinger  and  Westphal  and  Jolly. 

The  old  Pathological  Institute  I  have  al- 
ready referred  to.  It  was  founded  in  1856. 
Here,  indeed,  was  a  golden  hive.  First 
Johannes  Mueller's   proposal   for  a  professor 


Nera'e  Clinic — Charite 

of  pathological  anatomy  (a  then  unheard-of 
chair),  then  the  filling  of  the  chair  by  Vir- 
chow  and  behold — the  development  of  a  new 
epoch  in  medicine.  Besides  Virchow,  here 
were  also  Cohnheim,  Obermeier,  and  Lieb- 
reich.  And  of  Virchow's  assistants  who  went 
out  from  here  to  take  professorships  in 
other  universities  may  be  mentioned  Grohe, 
Klebs,    Recklinghausen,    Hueter,    Cohnheim, 

101 


MEDICAL  EUROPE 

Roth,  Ponfick,  Ortli,  Grawitz,  Hoppe-Seyler, 
Kuehne,  Liebreich,  and  Salkowski. 

But  the  men  of  the  Charite  are  not  all  of 
the  past.  Here  it  is  that  to-day  one  finds 
many  of  the  men  famous  in  the  world  of 
medicine.  At  the  head  of  the  new  Patho- 
logical Institute  is  Johannes  Orth,  a  worthy 
successor  to  the  great  Virchow,  and  associated 
with  him  are  Kaiserling  and  Davidsohn.  In 
medicine  there  are  von  Leyden  and  Kraus ;  in 
surgery,  Hildebrand;  in  children's  diseases, 
Heubner;  in  nerve  diseases,  Ziehen.  Really, 
the  list  is  too  long  to  detail. 


IX. 

BERLIX    CONTINUED HOSPITALS    AND    CLINICS 

LASSAR  AND   HIS  WORK HOFFA. 

There  may  be  cities  that  have  hospitals 
of  finer  construction  than  those  of  Berhn,  and 
there  are  others  that  have  hospitals  larger  than 
any  Berlin  yet  possesses,  but  there  is  no  city 
that  has  so  many,  so  fine,  and  so  large  hospitals 
as  are  to  be  found  in  the  German  capital. 

The  Charite,  which  is  perhaps  of  most 
interest  to  Americans  owing  to  its  connection 
with  the  University,  we  have  already  referred 
to.  But  of  no  less  interest  are  the  great 
groups  of  buildings,  scattered  throughout  the 
city,  known  as  "Die  Staedtischen  Kranken- 
haeuser. "  These  city  hospitals  in  Berlin  do 
not  stand  in  direct  relation  with  the  Univer- 
sity, as  they  do  in  many  other  German  cities, 
but  they  serve  their  ends  for  teaching  purposes. 
The  prosectors  (pathologists),  for  example, 
are  all  university  docents  or  professors,  and 
instruction  in  this  branch  is  given  to  students 
and  graduates,  as  well  as  research  places 
being  provided  for  suitable  men.  These 
hospitals  also  oifer  numerous  places  for  assist- 
ants, both  in  medicine  and  surgery. 

103 


MEDICAL  EUROPE 

These  city  hospitals  are  the  Moabit,  Turm- 
strasse  21;  Am  Friedrichsheim,  Landsberger 
Allee  159;  and  Am  Urban,  Urbanstrasse  139- 
150.  By  the  time  this  is  read  the  new 
Rudolph  Virchow  Hospital  will  be  open. 
Then  there  is  the  new  City  Hospital  in  Char- 
lottenburg,  which  is  essentially  a  part  of  Ber- 


Orth 


lin's  great  West  End.  The  Moabit  and 
Friedrichsheim  hospitals  are  old  in  a  sense, 
having  been  founded  in  1873  and  1874  re- 
spectively, but  are  essentially  up  to  date  in 
all  respects.  One  can  get  lost  amid  the  trees 
and  flowers  of  the  grounds  of  the  Moabit, 
although  it  is  in  the  heart  of  the  city.  Each  of 
these  hospitals  has  over  a  thousand  beds. 

104 


BERLIN 

It  is  the  new  Rudolph  VIrchow  Kranken- 
haus,  however,  that  attracts  the  attention  of 
the  visitor,  and  even  after  you  have  been  tokl 
all  the  wonders  of  this  institution  by  a  friend, 
your  surprise  is  none  the  less  keen  on  your 
first  visit.  This  place  is  not  an  institution — it 
is  a  town  in  itself;  a  beautiful  village,  with 
wide  streets  and  beautiful  gardens  and  magni- 
ficent trees.  There  are  fifty-seven  buildings  in 
this  village,  all  representing  the  highest  de- 
velopment of  architectural  and  hygienic  skill. 
There  are  large  buildings  divided  into  wards 
for  patients  that  are  temporary  and  do  not 
demand  the  care  and  expense  of  isolation. 
On  the  other  hand,  there  are  small  buildings, 
to  o;ive  most  careful  detailed  treatment  to  such 
patients  as  demand  special  care.  There  are 
laboratories  without  number;  chapel  and  con- 
servatory; everything,  in  fact,  that  one  can 
think  of.  This  hospital  will  care  for  eighteen 
hundred  sick.  It  covers  so  much  ground  that 
the  cost  of  land  alone  would  make  the  erection 
of  a  similar  institution  in  New  York  City,  in 
any  accessible  place,  prohibitive. 

Then  aside  from  these  great  city  hospitals 
there  is  a  list  of  private  institutions  too  long 
to  chronicle.  In  some  of  these  places,  how- 
ever, the  Americans  find  their  best  opportunity 
for  work.     In  the  x\ugusta  Hospital  there  is 

105 


JNIEDICAL  EUROPE 

Krause  the  surgeon,  and  Ewald  the  internist 
(he  does  not  Hke  to  be  called  "a  stomach 
man").  The  Jewish  Hospital  has  Israel  in 
surgery  and  Lazarus  in  medicine,  two  of  the 
leading  men  of  Berlin.    At  St.  Hedwig's  there 


Hf  ::?  I 


.*s».«    »•*? 


*       ^QP'^^ft^ifeSr:-? 


Grounds  of  Moabit  Hospital, 


is  Rotter  in  surgery  and  Wirsing  in  medicine. 
How  can  an  American  physician  who  is 
just  over  on  a  sightseeing  trip  and  does  not 
wish  to  stay  in  Berlin  for  extended  work,  see 
what  these  hospitals  have  to  oifer.^  Simply 
by  "butting  in."  Go  to  the  portier,  pass  out 
your  card,  and  a  mark   (two  bits),  and  you 

106 


BERLIX 

may  rest  assured  that  you  will  see  all  there  Is 
to  see.  It  is  really  remarkable,  how  German 
physicians  and  surgeons,  some  of  world-wide 
fame,  keep  their  good  nature  and  maintain  a 
uniform  courtesy,  interrupted  at  all  times  and 
all  hours  as  frequently  as  they  are  by  American 
visitors;  yet  I  have  not  known  of  a  single 
instance  where  courtesy  was  failing  to  a  visitor. 
In  fact  the  American  usually  complains  of  the 
detail  with  which  an  institution  is  shown  him, 
and  comes  away  from  a  hospital  at  which  he 
has  expected  to  spend  thirty  minutes  only 
after  a  three  or  four  hours'  personally  con- 
ducted tour. 

In  regard  to  hospital  calls  or  personal  calls 
on  particular  medical  men  one  wishes  to  see, 
a  word  can  be  said  regarding  cards.  The 
cards  that  some  x\merican  physicians  carry 
with  them  are  ludicrous.  They  are  large 
pasteboard  affairs  (I  have  seen  one  that  was 
engraved  on  aluminum)  covered  with  tele- 
phone numbers,  office  hours,  memberships  in 
county  medical  societies,  and  perhaps  also 
professorships  in  some  one-horse  medical 
college.  Such  cards  may  impress  the  poi'tier. 
I  remember  explaining  to  a  certain  sportier 
that  the  telephone  number  represented  the 
number  of  major  operations  the  man  had 
done,  and  the  office  hours  represented  his  fee 

107 


MEDICAL  EUROPE 

for  consultation  in  dollars.  If  anyone  who 
has  a  telephone  number  in  the  thousands,  and 
office  hours  from  9  to  12,  strikes  that  partic- 
ular portier,  he  will  "cut  ice." 

If  you  are  going  to  see  a  Berlin  professor's 
clinic  present  only  your  simple  engraved  visit- 
ing card,  with  your  city  written  in  pencil  in 
one  corner.  The  Germans,  it  is  true,  use  big 
cards  with  the  story  of  their  life  thereon,  but, 
notwithstanding,  they  know  that  such  are  not 
the  proper  thing  for  Americans. 

Interesting  and  instructive  as  are  the  hos- 
pitals of  Berlin  it  is  really  the  Polyklinik  that 
offers  the  greatest  attraction  for  the  Amer- 
ican. The  Polyklinik  corresponds  to  our  out- 
patient department.  Here  these  clinics  are 
tucked  away  almost  anywhere.  You  find  them 
at  every  turn.  A  narrow  stairway  over  a  little 
shop,  that  looks  like  the  thousands  of  other 
stairways  leading  to  the  apartment  of  the 
Berliner  (and  it  might  be  added  sotto  voce  the 
Berlinerin)  may  lead  you  to  the  clinic  of  some 
man  who  is  famous  throughout  the  entire 
medical   world. 

Many  chapters  might  be  written  concerning 
these  clinics  and  their  chiefs,  but  we  will  only 
visit  a  few. 

Max  Joseph  is  not  a  professor  in  the 
University,  but  he  is  one  of  the  most  popular 

108 


BERLIN 

teachers  of  skin  diseases  in  Europe.  He  is  a 
large,  well  built  man,  with  full  beard.  When 
he  talks,  he  separates  his  lips  widely  so  that 
two  even  rows  of  teeth  are  seen,  and  you  hear 
what  he  is  saying.  There  is  nothing  of  Ger- 
man deliberation  about  Max  Joseph's  clinic. 
It  is  a  three-ring  circus  and  Joseph  is  master 
of  all  three  rings. 

The  clinic-rooms  are  small  and  dirty  and 
poorly  lighted.  They  are  overcrowded  with 
pupils,  who  are  for  the  most  part  Russian 
Jews  and  have  a  formation  for  surrounding  a 
patient  that  ''  Hurry-up  "  Yost's  foot  ball  team 
couldn't  break  through.  Into  this  crowd  the 
patients  are  poured  by  the  dozen,  and  then 
the  performance  begins. 

Treatment,  diagnosis,  examination,  pathol- 
ogy, are  being  hurled  at  you  all  in  a  bunch. 
While  you  are  feeling  a  herpes,  Joseph  is  giv- 
ing you  the  treatment  of  alopecia,  and  as  you 
jump  for  the  alopecia,  you  find  Joseph  has 
dropped  that  and  is  demonstrating  an  epithe- 
lioma. Before  you  get  to  the  epithelioma  you 
are  caught  up  in  a  crowd  that  is  rushing  madly 
into  another  room  where  Joseph  is  already 
talking  about  an  infantile  eczema. 

"If  Joseph  had  not  been  a  great  derma- 
tologist," said  the  American  who  came  out 
with  me,  as  we    walked  down    Ziegelstrasse, 

109 


MEDICAL  EUROPE 

"he  would  have  been  a  fine  man  for  a  side- 
show barker." 

Just  across  Friedrichstrasse  and  down  Karl- 
strasse  is  the  chnic  of  Prof.  Oskar  Lassar.* 
Here  is  a  large,  well  constructed  clinic-room, 
with  projection  apparatus  and  well  arranged 
seats  for  the  students.  The  walls  of  the  room 
are  hung  with  diplomas  without  number, 
which  have  been  sent  to  Lassar  from  all  over 
the  world.  And  Lassar  deserves  them.  Las- 
sar should  go  down  in  history  as  the  greatest 
man,  or  at  any  rate  the  most  marvelous  man, 
Germany  has  ever  produced.  We  hear  of 
Goethe  and  Frederick  the  Great  and  Bismark. 
But  what  did  they  ever  do  ?  A  few  poems ;  a 
few  battles  won;  Germany  unified.  Almost 
any  man  of  ability  could  have  done  those 
things,  given  the  opportunity.  But  Lassar 
entered  upon  a  campaign  the  stupendousness 
of  which  can  only  be  conceived  by  those  who 
are  familiar  with  the  great  mass  of  Germans, 
and  who  has  met  them  in  a  crowd  on  a  hot 
day.  Lassar  has  made  the  majority  of  middle- 
class  Germans  recognize  the  value  of  a  bath. 
Since  Lassar  began  his  campaign  there  are 
men  and  women  in  Berlin  who  now  wash 
themselves.     Therefore  the  diplomas. 

*  Oskar  Lassar  died  from  injuries  received  in  an  automobile 
accident,  December  23,  1907. 

110 


BERLIX 

Lassar  is  himself  a  clean,  well-grooiiicd 
man,  with  ever  the  merriest  twinkle  in  his 
bright  eyes.  His  humor  is  delicious,  and  an 
hour  in  his  clinic  is  a  delight  worth  the  ex- 
pense of  a  trip  abroad  to  experience.  One 
forgets  he  is  learning  dermatology  in  the 
pure  joy  he  gets  from  seeing  Lassar  handle 
his  patients. 

A  poor  little  girl  comes  in  to  the  clinic 
with  xerosis  pigmentosa.  Those  disfiguring 
freckles  must  be  burned  away  with  the  red- 
hot  cautery.  Lassar  greets  the  girl  as  thougli 
she  were  a  princess.  "Shall  we  try  the  face 
to-day,  or  the  hand.''"  he  asks,  in  a  way  he 
might  say  to  a  friend  "  Will  you  have  sparkling 
buro;undv,  or  moselle.^" 

The  girl  averts  her  face  and  you  can  see 
the  tears  start  in  her  eyes.  She  stretches  out 
her  hand. 

"Ah,"  says  Lassar,  "the  liand.  That  is 
good.  x\nd  we  are  not  going  to  cry,  for  here 
are  ten  pfennings." 

There  has  been  a  slight  sizzling  sound  and 
we  get  a  faint  odor  of  burnt  flesh.  The  girl 
has  bit  her  lip,  but  the  tears  have  come  no 
farther.  In  her  free  hand  she  grasps  a  bright 
new  ten-pfennig  piece. 

"You  are  a  brave  girl  and  you  must  buy 
an    ansichts    Karte. "      There    is   the   sizzling 

111 


MEDICAL  EUROPE 

sound  again.  "An  ansichts  Karte  with  the 
picture  of  the  httle  Crown  Prince  on  it." 
Again  we  smell  the  flesh.  "Perhaps  that  will 
cost  twenty  pfennigs;  here  are  ten  more." 

The  tears  have  stayed  exactly  where  they 
started,  save  for  one  that  lies  on  the  freckled 
cheek,  and  the  girl  smiles  up  at  Lassar  as  he 
pats  her  on  the  shoulder  and  tells  her  to  come 
back  next  week,  and  perhaps  he  will  have 
some  more  ten-pfennig  pieces. 

We  go  out  of  Lassar' s  clinic  feeling  de- 
pressed. It  is  quite  a  strain  on  the  average 
human,  meeting  at  once  so  rare  a  type,  a 
great  and  good  man.  And  that's  what  Oskar 
Lassar  is. 

Not  far  from  Lassar's,  at  the  corner  of  Lui- 
senstrasse,  is  Frank's  genito-urinary  clinic. 
Frank  is  a  brilliant  and  energetic  young  Ger- 
man. He  is  a  splendid  speaker.  I  heard  him 
speak  for  three  hours  once  without  a  break. 
It  was  a  terrifically  hot  night  and  the  room 
was  like  a  furnace,  and  we  who  were  listening 
damned  the  prostate  gland.  We  had  known 
somewhat  about  it  before,  but  that  night  we 
got  its  most  intimate  life  history,  from  em- 
bryology to  senile  atrophy.  We  learned  its 
histology,  its  gross  and  microscopical  anatomy 
and  pathology,  the  palliative  and  operative 
treatment  of  all  its  diseases  in  detail.     While 

112 


wc  cursed  at  the  length  of  the  talk  and  wlille 
we  perspired  cjuarts  of  Pilsener,  nevertheless 
we  could  not  help  but  admire  the  fluent  and 
direct  sj)eech  of  the  lecturer,  who  never  paused 
for  a  word  or  repeated  a  sylla})le  in  all  those 
three  hours. 

Here  in  the  same  quarter,  Am  Zirkus  9,  is 
the  ort]ioj)a3dic  clinic  of  Prof.  Al})ert  Iloffa.* 
Iloffa  is  a  man  sought  out  })y  every  orthopae- 
dist who  goes  abroad.  He  is  a  big  and  busy 
man  witli  perhaps  the  most  remunerative 
j)ractice  of  any  surgeon  in  Berlin,  if  not  in 
all  Europe.  He  drives  up  to  his  clinic  in  a 
motor-car,  in  quite  American  style,  for  he 
has  been  in  America  and  has  learned  that  one 
can't  be  a  real  surgeon  in  the  U.  S.  A.  without 
owning  a  motor-car. 

If  you  have  a  letter  to  Iloffa  from  one  of 
his  very  intimate  friends  in  America  (a  friend 
of  mine  had  such  a  letter)  he  gives  you  the  run 
of  his  clinic  and  you  can  see  his  assistants 
operate  and  his  dieners  put  on  apparatus. 
After  you  have  been  there  a  month  he  may 
surprise  you  by  coming  in  some  morning  and 
instead  of  ignoring  your  existence  as  usual, 
throw  his  arms  around  your  neck  and  devote 
his  full  forenoon   to  you  exclusively.      Then 

*  Albert  HofFa  died  January  5,  1908  from  an  attack  of  angina 
pectoris. 

8  113 


MEDICAL  EUROPE 

you  are  again  ignored  for  some  weeks.  You 
are  about  to  chuck  up  Hoffa  and  go  over  to 
Wien,  when  you  receive  an  invitation  to  dine 
at  his  house.  You  get  into  your  Tuxedo,  hire 
a  droschke,  and  with  beating  heart  are  dropped 
before  the  door  of  a  magnificent  West  End 
home. 

Hoffa  in  his  home  (this  is  the  report  of  my 
friend)  is  a  royal  host.  He  (my  friend) 
came  home  at  three  a.m.  with  a  load  of 
Hoffa' s  autographed  text-books  on  the  seat 
beside  him,  and  with  that  exuberance  of  spirit 
under  his  belt  that  made  him  wake  me  up  just 
as  I  was  getting  my  beauty  sleep,  to  get  my 
aid  in  a  proper  rendition  of  the  "  Star  Spangled 
Banner,"  which  he  was  not  wholly  able  to 
differentiate  from  the  more  subtle  movement 
of  ''Die  Lustige  Witwe''  waltz. 

And  to  cap  it  all,  I  had  to  spend  the  greater 
part  of  the  next  day  explaining  to  my  friend's 
wife  that  it  was  an  insult  to  the  host  to  refuse 
an}i:hing  offered  you  when  being  entertained 
in  Germany,  so  that  it  really  wasn't  her  hus- 
band's fault.  Since  then  she  has  regarded  her 
spouse  as  a  martyr  to  barbaric  German  ideas. 


X. 

BERLIN  CONTINUED A   LITTLE  PILGRIMAGE  IN 

PATHOLOGY LUDWIG     PICK. 

Berlin  is  surely  a  Mecca  for  pathologists. 
Probably  there  is  no  better  place  in  Europe 
for  a  man  who  has  had  a  poor  course  in  pathol- 
ogy at  home  to  work  up  this  important 
branch  of  medicine.  At  several  of  the  big 
hospitals  there  are  from  five  to  ten  autopsies 
a  day,  with  courses  so  arranged  that  a  man 
can  do  the  postmortems  himself  or  make  use 
of  what  material  he  desires.  Then  the  courses 
in  pathologic  histology  are  numerous  and  par- 
ticularly adapted  to  the  needs  of  men  who  are 
stale  and  wish  to  brush  up.  For  the  advanced 
worker  in  pathology — for  the  man  who  has  a 
problem  he  wishes  to  work  out,  or  who  is 
looking  for  a  problem  to  work  out — the 
chances  are  equally  good.  Here  are  all  kinds 
of  material  at  one's  disposal,  and  plenty  of 
great  men  to  give  one  counsel. 

I  am  going  to  pass  over  some  of  the  greater 
men  and  the  larger  hospitals,  however,  in  this 
chapter.  The  man  who  comes  here  for  a 
week  sees  Orth,  for  instance,  and  the  great 
Pathologic  Institute  at  the  Charite,  and  writes 

115 


MEDICAL  EUROPE 

thereof.  We  all  know  that  Johannes  Orth  is 
a  great  man;  perhaps  the  greatest  pathologist 
living  to-day.  Benda  is  also  a  name  to  con- 
jure with  in  pathology.  Hansemann  and 
Kaiserling,  Israel  and  Oesterreich  and  Wes- 
tenhoeffer,  are  all  men  who  have  an  interna- 
tional reputation  in  pure  pathology.  Any  one 
of  them  is  worth  a  trip  to  Europe  to  see. 
With  all  due  respect  to  these  men,  I  am,  as  I 


say,  going  to  pass  them  by,  and  take  you  on 
a  little  pathological  journey  that  many  of  you, 
perchance,  have  made  yourselves. 

There  is  a  very  quiet  street  in  the  north- 
western part  of  Berlin  which  you  can  get  to 
either  by  one  of  the  new  automobile  busses  on 
Friedrichstrasse,  aided  by  a  short  walk,  or 
more  directly  by  a  Luisenstrasse  tram.  This 
street  is  Philippstrasse.  If  you  have  come  by 
the  tram  you  have  only  to  walk  a  few  steps, 

116 


BERLIN 

when  you  come  to  a  door  flanked  on  one  side 
by  the  danghng  brass  plate  of  a  Friseur  and  on 
the  other  by  the  equally  arrestive  brass  sugar- 
loaf  cone  of  a  Delicatessen.  The  number  over 
the  door  is  21.  You  go  through  the  door 
and  on  through  a  court-yard  to  a  red  brick 
dwelling  covered  with  green  vines.  You  enter 
this  building,  turn  to  the  left,  and  walk  up 
four  very  long  flights  of  steep  stairs,  and  enter 


a  small  room,  lighted  from  the  roof  ])j  small 
windows.  In  this  room  there  are  some  long 
unpainted  tables  and  a  dozen  or  so  roughly 
fashioned  three-legged  stools. 

Away  oflf  in  Little  Rock,  or  in  Bombay,  or 
in  Glasgow,  or  in  Buenos  Ayres,  or  in  Mos- 
cow, or  in  Cape  Town,  or  in  Tokio,  or  in  any 
place  in  the  world  where  some  man  has 
recognized  the  fact  that  Medicine  is  a  beau- 
tiful woman  but  a  woman   who   reveals   her 

117 


MEDICAL  EUROPE 

charms  only  as  knowledge  advances  to  meet 
and  appreciate  them — away  off  there,  the  man 
is  packing  his  grip  and  is  going  to  seek  for 
knowledge  that  he  may  become  more  worthy 
of  his  chosen  mistress.  He  will  sail  the  seas 
in  a  big  ship,  and  he  will  take  the  automobile 
bus  on  Friedrichstrasse  or  the  tram  on  Luisen- 
strasse,  and  he  will  pass  the  brass  plate  or  the 
arrestive  sugar  loaf,  and  he  will  climb  the  four 
flights  of  narrow,  steep  stairs,  and  sit  on  the 
three-legged  stool  at  the  unpainted  table.  For 
here  shall  they  all  meet;  they  who  have 
lived  in  the  half  light  of  a  beautiful  mistress, 
whose  charms  they  are  now  more  fully  to 
realize. 

Far  be  it  from  me  to  characterize  Dr.  Lud- 
wig  Pick  as  merely  the  High  Priest  of  the 
Temple.  Dr.  Pick  is  very  much  a  man.  He 
is  short  and  fat  (you  may  insert  the  quali- 
fying adjective  "very"  before  each  without  ex- 
aggerating). His  hair  is  closely  cropped  and 
he  wears  a  "Kaiser  Wilhelm"  moustache  with 
well-trained  ends  pointing  upward.  (Is  it  true 
that  the  upward  trend  of  thought  character- 
istic of  Germany  is  symbolized  by  the  direction 
of  the  hair  of  the  upper  lip  ?)  He  flashes  on 
you  a  keen  and  penetrative  eye,  which  has  a 
lurking  gleam  of  humor  in  its  depths,  and  he 
greets  you  in  perfect  English,  if  you  are  an 

lis 


BERLIX 

American,  or  in  equally  good  French  if  you 
are  a  Frenchman. 

On  his  cheek  and  forehead,  if  you  look 
closely,  you  will  see  the  scars  of  his  old  Mensur 
days,  for  Dr.  Pick  admits  that  he  was  once 
young  and  foolish.  I  would  say  more  about 
these  scars  but  I  pride  myself  on  the  fact  that 
I  am  the  only  man  w  ho  ever  wrote  of  Germany 
without  ringing  in  a  student  duel.  (The  artist 
couldn't     suppress     himself,     however,     and 


threatened  to  stop  work  if  I  didn't  give  him 
a  charLce  to  illustrate  such  an  event.) 

Dr.  Pick  is  a  w^orker.  Every  morning  he 
is  in  his  laboratory  at  six  o'clock,  and  he 
does  not  leave  it  till  seven  or  eight  o'clock  at 
night,  except  to  go  out  to  do  his  autopsies, 
and  to  get  shaved  at  five  o'clock.  His  time 
is  divided  between  teaching  and  research. 
The  average  American  pathologist  w^ould  con- 
sider himself  swamped   if   he   had  to   devote 

IID 


MEDICAL  EUROPE 

the  amount  of  time  to  teaching  that  Pick  does. 
But  a  German  pathologist  must  teach  to  earn 
a  hving.  Between  the  teaching  hours,  then, 
are  grasped  the  moments  in  which  Pick  has 
to  do  his  research  work.  The  abihty  to 
generate  the  amount  of  energy  required 
to  accomphsh  what  he  has  done  is  a  rare 
quahty. 

Pick  has  produced  over  forty  articles  on  a 
wide  variety  of  pathological  subjects,  and  all 
the  articles  are  exhaustive  and  weighty.  Pick 
has  made  no  great  discoveries.  Great  dis- 
coveries are  more  or  less  a  matter  of  luck. 
But  the  work  he  has  done  has  been  of  great 
importance  to  pathology.  Space  is  too  brief 
here  to  go  into  his  work  in  detail,  but  his 
classic  studies  on  hypernephroma  and  on 
chorion  epithelioma  should  be  mentioned.  He 
has  added  much  to  our  knowledge  of  gynaeco- 
logical pathology;  he  has  given  us  many  new 
facts  in  the  field  of  malignant  new  growths; 
he  has  settled  many  moot  points  in  general 
pathology. 

Pick  has  found  time,  moreover,  to  put 
together  one  of  the  best,  although  by  no 
means  the  largest,  collections  of  gross  patho- 
logical specimens  in  Europe.  These  speci- 
mens are  all  preserved  in  their  natural  colors 
by  Pick's  own  method  of  color  preservation. 

120 


BERLIN 

Every  specimen  Is  a  gem;  far  different  from 
the  motley  mass  of  useless  and  poorly  pre- 
served material  one  sees  in  so  many  museums. 
The  part  of  tliis  collection  embracing  gynaeco- 
logical pathology  represents  work  done  at  the 
Landau  clinic.  The  general  pathological 
anatomical  material  was  obtained  from  the 
Juedische  Krankenhaus  and  the  Friedrich 
Wilhelm  Hospital.  For  Dr.  Pick  was  prosector 
to  both  these  institutions — work  enough  in 
itself,  in  the  mere  doing  of  autopsies,  to 
content  the  average  man.  But  Pick  is  not 
one  of  the  average  men;  he  is  one  of  those 
individuals  of  more  vigorous  mental  and 
physical  powers  than  the  others,  of  whom, 
as  Darwin  puts  it,  a  new  species  is  made. 

Personally,  Dr.  Pick  admits  that  he  has  but 
two  primary  interests  in  life — scientific  inves- 
tigation and  teaching.  And  though  still  a 
young  man  (he  is  yet  some  years  short  of  the 
forty-year  limit)  he  has  seen  already  tangible 
results  from  his  labors.  His  scientific  work  is 
known  wherever  there  are  pathologists;  his 
success  as  a  teacher  is  shown  by  the  men  who 
come  to  him  from  all  over  the  world.  If  he 
should  come  to  America  there  would  hardly 
be  a  city  of  any  size  from  New  York  to  San 
Francisco  in  which  he  would  fail  to  find  a 
former  pupil. 

121 


MEDICAL  EUROPE 

Although  Pick  rarely  gets  away  from  his 
laboratory  (except  at  long  intervals  for  a  day's 
fishing  in  the  country)  he  is  one  of  the  most 
cosmopolitan  of  men.  The  reason  is  that  he 
fairly  bristles  with  (what  Ehrlich  might  term) 
receptors. 

He  gets  something  from  every  man  who 
comes  to  him,  besides  the  few  marks  they  pay 
for  their  courses.  He  knows  what  is  going 
on  everywhere,  and  he  remembers  what  he  is 
told.  He  can  talk  with  you  intelligently 
about  Tammany  Hall  or  the  Russian  Duma. 
He  knows  who  sings  in  grand  opera  in  Buenos 
Ayres,  and  what  America  is  doing  in  the 
Philippines. 

In  regard  to  literature,  one  would  think 
from  the  broad  grasp  he  has  on  scientific 
work  (which  work  is  now  so  massive  that  the 
ordinary  man  does  not  attempt  to  keep  up  on 
more  than  the  head  lines)  that  he  would  have 
time  for  nothing  else.  But  he  can  talk  to  you 
about  Dickens  and  Shakespeare  (which  he 
reads  in  the  original),  and  Sherlock  Holmes 
is  one  of  his  heroes. 

Dr.  Pick  is  a  single  man.  If  you  discuss 
marriage  with  him  he  will  tell  you,  perhaps, 
that  all  women  worthy  of  consideration  are 
intelligent  or  beautiful  and  that  either  class  is 
equally  successful  in  distracting  you  from  your 

122 


BERLIN 

work.  He  also  says,  that  ''love  Is  an  acute 
psychosis  that  may  always  be  given  a  good 
prognosis."  Notwithstanding  these  frivolous 
remarks  Pick  has  a  deep  respect  and  regard 
for  women  and  he  said  to  me   seriously  one 


evening:  "I  am  in  my  laboratory  from  six 
in  the  morning  till  seven  or  eight  at  night. 
It  would  not  be  fair  under  those  conditions 
for  me  to  marry." 

Pick  is  an  egotist.  Personally  I  think  a 
man  who  has  made  good,  as  Pick  has  made 
good  by  sheer  ability  and  work,  has  a  right 

123 


MEDICAL  EUROPE 

to  be  an  egotist.  A  man  who  is  better  than 
the  average  man  and  does  not  know  it,  or 
doesn't  show  it,  is  either  a  fool  or  a  hypocrite; 
and  in  either  event  equally  uninteresting.  By 
being  an  egotist  I  mean  that  Pick  believes  in 
himself;  in  the  high  quality  of  his  scientific 
work;  in  his  ability  to  teach  pathology,  and 
that  he  brags  about  what  he  does.  I  do  not 
mean  that  he  has  no  consideration  for  others. 
On  the  contrary,  he  is  one  of  the  most  altruis- 
tic men  I  know.  He  will  give  you  the  best  he 
has  of  knowledge  and  advice.  He  will  save 
nothing  for  himself  if  it  will  help  you.  He  is 
considerate  of  those  beneath  him.  He  takes 
oif  his  hat  to  the  scrubwoman  when  he  meets 
her  on  the  stairs. 

None  of  us  will  climb  the  four  flights  of 
stairs  again  at  the  Landau  clinic  to  meet  the 
hearty  hand-shake  of  Dr.  Pick  or  to  sit  on  the 
three-legged  stools  at  the  bare  tables,  for 
Dr.  Pick  has  recently  been  appointed  to  the 
directorship  of  Friedrichshain,  to  succeed  von 
Hansemann,  a  great  honor  for  so  young  a 
man.  When  we  go  to  see  him  again  it  will  be 
to  one  of  the  largest  hospitals  in  Europe,  but 
Dr.  Pick  will  meet  us  with  the  same  cordial 
welcome  as  of  old.  The  men  in  St.  Louis 
who  have  been  his  pupils  recently  sent  him  a 
loving  cup,  in  honor  of  his  election  to  his  new 

124 


BEKLIX 

})Ositioii.     A  j)art  of  Dr.    Pick's  reply  on  the 
receipt  of  the  gift,  is  as  foUows: 

*'  I  have  in  my  treasure  more  than  one  letter 
from  your  countrymen  wliich  sliows  me  that 
many  threads  of  sympathy  and  friendsliip  join 
me  with  your  country  over  tlie  hirge  sea.  I 
am  sorry  c)nly  that  my  arm  is  not  so  long  as 
my  gratitude,  otherwise  every  one  of  you 
would  feel  my  personal  hand-shake.  I  take 
the  beautiful  cup  in  my  hand  and  thank  you 
for  all  your  kindness  in  German  luaiuier.  I 
fill  the  cup  with  golden  wine  of  our  beautiful 
Rhine  and  drink  it  to  the  health  and  the 
personal  prosperity  of  my  St.  Ixjuis  pupils." 

Here,  then,  is  a  lovable  man.  \  man  who, 
although  he  has  devoted  his  whole  life  to  sci- 
ence, radiates  a  personality  that  makes  every- 
one who  meets  him  keep  in  toucli  with  him 
and  come  back  to  him  again  at  the  first  oppor- 
tunity. There  have  been  men  like  him  in  other 
lines  of  life,  men  who  left  l)ehind  them  some- 
thing more  than  the  bare  bones  of  their  work 
for  the  world  to  rejoice  in.  Such  men  were 
Whistler  in  art,  Voltaire  in  literature,  Lincoln 
in  statesmanship;  men  whose  names  recall  a 
fund  of  incident  and  anecdote  that  makes  us 
more  anxious  to  read  biography  than  does  the 

125 


MEDICAL  EUROPE 

work  of  equally  great  but  personally  uninter- 
esting men.  Probably  Pick  will  never  have  a 
Bos  well,  for  pathologists  are  "  no  thin  red  line 
of  heroes,"  and  nobody  outside  a  very  small 
coterie  knows  that  the  class  exists,  anyway. 
But  if  Pick  were  a  great  artist  or  a  great 
statesman  or  even  a  modern  novelist,  his  epi- 
grams and  delightful  mannerisms  could  be 
written  into  as  interesting  a  volume  as  I  would 
ever  ask  to  read. 

Ludwig  Pick,  however,  doesn't  want  any 
biographer.  All  he  wants  is  a  ''two  millimetre 
apochromat"  with  a  piece  of  diseased  tissue  at 
one  end  of  it  and  his  eye  glued  to  a  compen- 
sating ocular  at  the  other  end.  And  here  we 
will  leave  him,  with  our  best  wish  that  it  will 
be  a  great  many  years  before  that  eye  and  the 
compensating  ocular  get  a  divorce. 


XL 

VIENNA AN    IDEAL    PLACE    FOR    MEDICAL 

STUDY STUDENTS  A  GAY  SET. 

Vienna  has  always  been  associated  in  my 
mind  with  a  piece  of  music;  an  air,  that  you 
all  know,  and  all  associate  with  your  youth. 
I  remember  it  first  as  a  tune  I  was  compelled 
to  beat  out  of  a  wheezy  melodeon  when  I 
was  ten  years  old. 

I  remember  it  later,  in  my  college  days,  as 
the  tune  the  band  played  when  I  waltzed  with 
the  girl  I  loved.  And  who  doesn't  always  love 
the  girl  he  is  waltzing  with,  when  the  band 
plays  the  "Beautiful  Blue  Danube!"  Even 
in  mv  more  sedate,  medical-student  davs,  I 
was  likely  to  get  sentimental  when  Max  Zach 
started  that  old  waltz,  which  always  has  a 
place  on  the  program  at  the  Boston  Sym- 
phony Pops. 

I  didn't  hear  the  tune,  however,  while 
I  was  in  Wien,  though  I  sailed  down  the 
"Beautiful  Blue  Danube,"  which  is  neither 
blue  nor  beautiful.  In  fact,  it  is  decidedly 
muddy  and  ordinary.  But  the  trip  is  full  of 
interest.  On  the  little  steamer  (that  I  had  to 
turn   out   about   five   o'clock  in   the   morninof 

o 

127 


MEDICAL  EUROPE 


to  catch)  were  a  number  of  Austrian  army 
officers.  They  were  gay  dogs,  a  dozen  of 
them,  in  their  brilhant  uniforms,  flirting  out- 
rageously with  a  red-headed  girl  who  was  on 
board  and  who  was  wholly  indifferent  to  their 
multiple  attentions.  Then,  there  was  the 
most  excellent  Magyar  wine,  which  I  met  for 

the  first  time,  and  real 
Hungarian  Goulash 
(not  Irish  stew  with 
paprika) .  Best  of  all, 
was  the  entrance  just 
at  sunset  into  Buda- 
pest, the  most  beau- 
tiful city  in  Europe. 
Budapest,  with  its 
magnificent  water 
front,  its  wonderful 
palaces  and  public 
buildings,  its  well- 
ordered  hospitals,  its 
splendid  streets,  its  gay  cafes  and  strikingly 
beautiful  women,  is  a  joy  and  delight.  The 
medical  men  who  are  working  in  Vienna 
never  fail  to  make  an  occasional  trip  down 
to  this  beauty  spot  to  spend  a  Sunday. 

I  did  not  go  to  Vienna  for  medical  work, 
and,  therefore,  this  chapter  is  mostly  a  very 
inadequate  sketch  of  a  city  that,  from  a  medi- 

128 


A  Wiener  Type 


VIENNA 

cal  standpoint,  should  have  a  whole  book  to 
itself.  Berlin  and  Vienna  are  without  ques- 
tion the  two  greatest  medical  centres  of  the 
world.  Which  should  have  first  place  is  a 
matter  of  opinion.  One  man  will  tell  you  that 
Vienna  has  had  first  place  in  the  past,  but  has 
seen  her  best  days,  and  that  she  is  now  rather 
dead.  Another  will  tell  you,  just  as  sincerely, 
that  Vienna  has  just  begun  to  come,  that 
there  is  no  city  in  the  world  that  has  shown 
such  a  marked  progress  in  the  last  few  years; 
that  if  you  want  a  live,  up-to-date  town,  you 
must  come  to  Vienna. 

Of  these  opinions,  you  can  take  your  choice. 
Personally,  I  found  here  a  pleasing  mixture 
of  old  and  new.  And  as  far  as  first  place  in 
medicine  goes,  there  is  ten  times  as  much 
material  as  you  could  use  in  a  lifetime,  and 
ten  times  as  many  brilliant  young  and  fam- 
ous older  men,  as  you  could  ever  expect  to 
work  with,  both  in  Vienna  and  Berlin. 

While  the  past  fairly  bristles  with  great 
names  (and  Rokitansky,  Hyrtl,  Hebra,  Bill- 
roth, and  Nothnagel  may  be  mentioned 
among  this  number),  nevertheless,  the  present 
offers  its  full  share  of  famous  men  in  all 
branches  of  medical  work.  Here  are  to  be 
found  Eiselsberg,  Schauta  and  Wertheim  in 
surgery,    obstetrics     and    gynaecology  respee- 

131 


MEDICAL  EUROPE 

lively;  Lorenz  the  orthopedist;  Neusser,  Yon 
Noorden,  Ortner,  and  Kovacs  in  medicine; 
Escherich  in  children's  diseases;  Fuchs  and 
Schnabel  in  ophthalmology;  Wagner  and 
Chvostek  in  neurology;  Riehl,  Finger  and 
Ehrmann  in  dermatology. 


ALL(iKMi:iNF,S    KraXKEXHAVS — YlKNNA 


In  the  laboratories  are  Toldt  and  Zuker- 
kandle  in  anatomy,  and  Shaffer,  Ebner,  and 
Rabl  in  histology.  There  are  Weichselbaum 
in  general  pathology,  and  Paltauf  in  experi- 
mental pathology.  Exner  is  chief  of  the 
department  of  physiology. 

Of  Exner,  a  very  good  story  is  told.  And 
one  might  mention,  incidentally,  that  Vienna 
is    rich  in    medical    stories.     At   the    Univer- 


132 


VIENNA 

sity,  a  joke  book  is  kept  in  which  is  written 
the  amusing  answers  that  students  have  given 
from  time  to  time,  as  well  as  jokes  that  have 
been  turned  on  the  professors,  as  in  the 
present  instance.  Exner,  as  everybody  knows, 
suffered  from  goitre,  which  had  received  the 
usual  treatment.  One  day  at  recitation, 
Exner  asked  in  the  course  of  a  quiz  on  goitre, 
"What  is  the  result  when  the  thyroid  gland 
is  removed.^"  "Why,"  replied  the  student, 
"the  patient  becomes  an  idiot."  "In  all 
cases  .^"  asked  Exner.  "Yes,  Professor," 
the  student  replied,  earnestly;  "in  every 
instance." 

Another  story  is  told  of  a  well-known 
Vienna  professor  that  points  too  good  a  moral 
for  medical  teaching  in  general  to  be  passed 
by.  This  Professor  brought  to  the  class  one 
day  a  most  rare  kidney  lesion,  one  that  a  man, 
with  all  kinds  of  material  at  his  disposal, 
would  run  across  onlv  once  in  a  lifetime. 
The  kidney  was  exhibited  to  the  class,  with 
all  the  wealth  of  detail  that  the  Professor 
could  lavish  upon  it,  for  a  full  hour.  After 
the  lecture,  one  of  the  students  came  up  and 
asked  very  naively:  "By  the  way.  Professor, 
would  you  mind  telling  me  whether  the  kid- 
ney is  normally  situated  above  or  below  the 
diaphragm.^" 

133 


MEDICAL  EUROPE 

The  medical  centre  of  Vienna  is  the  Cafe 
Khnik;  and  the  Allgemeines  Krankenhaus 
owes  its  fame  to  being  situated  in  its  neigh- 
borhood. This  hospital  of  2600  beds  is  one 
hundred  and  thirty  years  old,  but  is  now  in 
process  of  reconstruction.  While  some  of  the 
new  buildings  are  already  occupied,  still  it 
will  be  fifteen  years  before  the  whole  replace- 


Dear  Doctor. 

The  next  meeting  of  the  American  Medical 
Association  of  Vienna  will  be  held  Saturday  evening 
May  13*''  at  »Restaurant  zum  Senator«  No.  19  Reichs- 
rathsstrasse. 

Supper  a  la  carte  at  7  P.M. 

Prof.  Hermann  Nothnagel  will  address  the  mee- 
ting on  1he  progress  of  medicine  since  my  student 
days:  (1854.)'/ 

Every  body  come  and  bring  your  american 
medical  friends. 


H.  H.  KLEINPELL 

Secty. 


ment  is  completed.  The  centralization  of 
work  and  grouping  of  post-graduate  courses, 
made  possible  by  the  great  amount  of 
material  at  this  one  hospital,  make  Vienna  so 
ideal  a  place  for  medical  study.  In  Berlin, 
London,  and  Paris,  much  time  that  can  be 
spent  to  better  advantage  is  wasted  in  getting 
to  remote  parts  of  the  city. 

As  in  Berlin,  there  is  a  society  of  American 

134 


VIENNA 

students  which  you  affihate  yourself  with  at 
once;  all  good  fellows,  who  make  you  feel  at 
home  immediately.  The  office  of  the  club  is 
at  the  Cafe  Klinik,  Spital  und  Lazarath  Gasse. 
I  quote  the  following  from  their  constitution: 

"  The  purpose  of  the  society  is  to  promote  the  social 
intercourse  of  its  members  ;  to  furnish  information  for  the 
rapid  orientation  of  new  members  in  regard  to  boarding- 
houses,  rooms,  restaurants,  etc.;  to  provide  information  in 
regard  to  the  scope  and  relative  value  of  courses  ;  to 
promote  the  scientific  advancement  of  its  members." 

One  of  the  fine  things  the  American  Med- 
ical Association  of  Vienna  has  done  is  the 
arrangement  with  the  dean  of  the  post-grad- 
uate department  of  the  University  whereby 
courses  are  given  on  every  desired  branch  of 
medicine  and  whereby  the  prices  of  these 
courses  remain  definite. 

The  following  post-graduate  courses  are 
offered : 

I.  Normal  and  Pathologic  Histology  of  the 
(a)  alimentary  tract;  (b)  blood;  (c)  circul- 
atory system;  (d)  ear;  (e)  eye;  (f)  genito- 
urinary tract  in  both  male  and  female;  (g) 
nervous  system;  (h)  nose  and  throat;  (i) 
respiratory  system ;  (j)  integumentary  system ; 
(k)  osseous  system. 

II.  Embryology. 

135 


MEDICAL  EUROPE 

III.  Bacteriology;  principles  of  immunity 
(antitoxin,  cytotoxins,  agglutinins,  precipitins, 
serodiagnosis),  and  forensic  blood  examina- 
tions. 

IV.  Gross  Anatomy,  general  and  regional. 

V.  Internal  Medicine. 

VI.  Diseases  of  the  stomach  and  intestines. 

VII.  Diseases  of  the  blood  and  blood- 
making  apparatus. 


Administration  Building.     General,  Hospital — Vienna 


and 


nervous 


VIII.  Diseases   of   the   mind 
system. 

IX.  Surgery:    (a)  diagnosis;    (b)  operations 
on  the  cadaver;    (c)  orthopaedic  work. 

X.  Radiography  and  radiotherapy. 

XI.  Gynaecology  and  obstetrics. 

XII.  Ophthalmology. 

XIII.  Otiatry. 

XIV.  Rhinology. 

136 


VIENNA 

XV.  Pediatrics:  (a)  diagnosis;  (b)  intuba- 
tion and  tracheotomy. 

XVI.  Diseases  of  the  integumentary  system 
and  syphihs. 

These  courses  are  offered  to  sections  of  two 
to  ten  men  for  a  fee  ranging  from  ten  to 
twenty  dollars  a  course. 

Now  that  I  have  gotten  all  this  out  of  my 
system,  I  can  speak  of  a  few  other  things 
about  Wien  that  interested  me.     First  of  all, 


Park  ix  Gexeral  Hospital — Yienxa 


I  found  that  at  ten  o'clock  the  outer  door  of 
my  pension  was  locked  and  that  I  had  to 
pay  the  portier  20  hellers  (4  cents)  to  be 
admitted.  As  nobody  goes  to  bed  in  Wien 
before  ten  o'clock,  I  figured  that  the  average 
portier  could  save  enough  to  retire  on,  in  a 
few  years,  and  lead  a  life  of  luxury  and  ease, 
provided  he  had  the  constitution  to  stand  the 
strain  of  continuous  loss  of  sleep  incident  to 
his  position. 

137 


MEDICAL  EUROPE 

The  Viennese  are  a  very  polite  people; 
kissing  the  hand  of  a  lady  is  far  from  an  obso- 
lete custom.  The  greetings  and  departures 
are  even  more  complicated  than  in  Germany. 
''Ich  habe  die  ehre''  is  the  favorite  form  of 
greeting.  This  is  elided  by  gliding  over  the 
first  two  words  so  quickly  that  I  constantly 
felt  as  though  the  people  I  met  were  calling 
me  "dearie";  for  that  popular  song  was  just 
then  in  vogue. 

Medical  students  everywhere  are  a  jolly 
lot,  and  the  atmosphere  of  Vienna  tends  in 
no  way  to  diminish  their  gayety,  so  that  an 
evening  about  the  town  with  the  fellows  is 
an  event  not  soon  to  be  forgotten.  A  new- 
comer, however,  is  likely  to  be  put  through  a 
course  of  sprouts  that  would  equal  the  trials 
of  a  tenderfoot  in  a  bunch  of  cowboys. 

For  instance,  the  visiting  card,  which  a 
new  arrival  passes  out  to  each  man  he  meets, 
is  frequently  put  to  strange  uses.  Suppose  a 
crowd  of  students  have  been  out  rather  late 
and  have  made  considerable  use  of  a  cab. 
Now,  it  is  easy  to  have  a  row  with  the  cabman 
and  accuse  him  of  overcharge.  Matters  of 
overcharge  are  settled  by  the  police,  and  the 
student  gives  the  cabman  his  card,  saying  he 
will  settle  with  the  proper  authorities.  In 
reality,  he  gives  the  cabman  the  card  of  the 

138 


VIENNA 

new  arrival.  The  next  morning,  the  innocent 
stranger  is  awakened  by  a  visit  from  the 
pohce  and  is  dragged  to  the  pohce  station. 
There  he  learns  in  a  vague  sort  of  way  (for 
he  usually  doesn't  speak  much  German)  that 
there  is  something  wrong  in  regard  to  his  not 
paying  somebody  enough  cab-fare,  and,  rather 
than  have  a  row,  he  pays.  You  should  guard 
your  visiting  cards  while  in  Vienna. 


Cakkyi^g  Food  I'O  Patients 


XII. 

PARIS THE    SAINT    LOUIS    HOSPITAL SCENES 

AT  THE  SKIN  CLINIC. 

Personally,  there  is  a  charm  about  Paris 
that  appeals  to  me.  It  is  the  one  city  above 
all  others  that  has  a  personality. 

When  I  have  finally  succeeded  in  giving  my 
cocker  money  enough — not  to  satisfy  him, 
but  to  escape  from  his  presence  without  a 
following  volley  of  curses;  when  I  have 
agreed  to  pay  my  old  landlady  in  the  Rue 
Valette  a  franc  a  day  more  than  I  did  the 
year  before,  for  a  worse  room  than  I  had  the 
previous  summer;  and  when  I  have  purchased 
a  four-inch  brown  rope,  facetiously  termed  a 
cigar  (the  Parisians  are  great  humorists),  for 
three  times  the  amount  I  pay  for  a  real  cigar 
in  Germany,  then  I  say,  "At  last  after  all 
my  wandering  I  am  really  for  the  first  time 
abroad." 

Frankly,  I  admit  that  Paris  is  a  dirty, 
badly-kept  city;  that  its  amusements  are  plan- 
ned to  meet  the  tastes  of  the  average  New 
England  school-teacher;  that  the  Moulin 
Rouge  is  no  more  wicked  than  Keith's  Boston 
Theatre;   that  the  majority  of  the  restaurants 

140 


erg 


ti.o 


o  ^ 

fC    i-s 

^2 


"it 


o   s  -- 


P  -2 

s  s:  P   S 

O     "^  ?5      O 

PCfQ  p*      2 

0)    ft  &-  K 

1-^  p 

H  CI- 


w 
o 

tH 


PARIS 

arc  not  fit  to  cat  in,  and  the  greater  part  of 
the  wine  served  you  is  not  fit  to  preserve 
pathological  specimens  in.  I  will  admit  that 
Parisian  shop-keepers  are  the  greatest  grafters 
in  the  world;  that  Parisian  hotel-keepers  are 
robbers;  that  Parisian  cab-drivers  and  guides 
are  worse  tlian  bandits.  I  will  admit  that  in 
an  August  afternoon  you  will  see  more  Amer- 
icans pass  Cook's  than  you  can  count  in  the 
same  time  passing  Mermod  and  Jaccard's  in 
St.  Louis.  I  will  agree  that  Paris,  as  we  have 
formed  our  idea  of  it,  is  the  exact  opposite  of 
everything  we  believed — and  yet  I  like  Paris 
the  best  of  any  city  in  Europe  and  I  do  not 
feel,  as  I  stated  above,  that  I'm  really  abroad 
till  I  settle  back  in  a  voiture  and  feel  the  pulse 
of  the  Paris  pavement  softly  transmitted 
through  its  rubber  tires. 

There  is  much  of  interest  in  Paris  for  the 
American  physician  and  medical  scientist,  al- 
though medical  men  do  not  come  here  to 
study  as  they  go  to  Berlin  and  to  Vienna. 
There  are  no  courses  arranged  in  the  neat 
packages  which  the  hurrying  physician  can 
take  away  with  him  for  a  small  fee,  like  sand- 
wiches from  a  railway  lunch-counter,  as  there 
are  at  the  latter  places. 

In  France  medicine  is  an  art,  and  it  is  on 
the  whole  much  more  scientific  than  in  Amer- 

143 


MEDICAL  EUROPE 

ica,  and  the  American  who  has  a  year  or  more 
to  spare  can  learn  much  in  Paris.  The  best 
proof  of  this  is  the  fact  that,  for  special 
branches  at  least  (notably  dermatology  and 
genito-urinary  diseases),  Germany  sends  her 
best  men  to  France  for  special  training. 
And  Germany  doesn't  go  to  France  for  any- 
thing that  she  doesn't  have  to  go  for. 

The  hospitals,  laboratories,  and  clinics  of 
this  great  city  are  too  numerous  to  chronicle 
in  the  way  they  deserve,  and  I  must  ask  par- 
don for  merely  referring  to  such  as  were  of 
interest  to  me. 

In  the  eastern  quarter  of  Paris,  apart  alike 
from  the  gay  throngs  of  the  boulevards,  the 
distractions  of  Montmartre,  and  the  vivacious 
life  of  the  Quartier  Latin,  is  an  aggregation 
of  buildings  enclosed  by  a  high  brick  wall, 
which  includes  several  city  blocks.  The 
entrance  to  the  grounds  is  through  a  low  arch- 
way that  suggests  the  gate  of  one  of  the  old 
fortified  French  towns.  This  is  the  Saint 
Louis  Hospital,  famous  throughout  the  world 
for  its  great  skin  clinic,  its  museum  filled  with 
wax  reproductions  of  all  known  skin  diseases, 
and  its  renowned  skin  specialists,  Gaucher, 
Fournier,  De  Bourmann,  Gaston,  and  Sa- 
bouraud. 

I   went  there   primarily  to   see  the   much- 

144 


PARIS 

talked-of  '* bald-headed  clinic"  of  Sabouraud. 
Every})ody  lias  heard  of  this  clinic,  where 
those  who  have  lost  their  hair  come  by  hun- 
dreds, and  of  the  great  Sabouraud  who  pulls 
a  hair  (provided  there  is  one  remaining) 
from  your  head,  glances  at  it,  and  says  "Yes, 
I  can  cure  you;  go  into  the  next  room";  to 
another,  "You  may  be  benefited;  wait  here"; 
and  to  a  third,  "Go  and  buy  a  wig;  noth- 
ing can  be  done  for  you."  It  is  said  that 
Sabouraud  can  tell  your  moral  character,  the 
amount  of  your  yearly  income,  and  what  you 
have  eaten  for  breakfast,  by  looking  at  a  root 
of  one  of  your  hairs.  We  will  admit  that 
this  is  perhaps  exaggeration,  but  we  want  to 
prove  the  point  that  he  is  a  great  man,  a  man 
every  dermatologist  in  every  civilized  country 
has  heard  of.  Therefore  I  was  somewhat 
surprised  when,  stopping  a  uniformed  attend- 
ant in  the  courtyard  anrl  asking  for  Sabour- 
aud's  clinic,  the  attendant  told  me  he  didn't 
know  of  such  a  man.  I  saw  a  nurse  hurrying 
past,  however,  and  asked  her.  She,  too,  pro- 
fessed ignorance  with  an  extenuating  smile, 
which  I  accepted  at  its  face  value.  Finally  I 
captured  a  young  house  physician  and  he 
directed   me. 

All  this  is  apropos  of  a  prophet's  honor  in 
his  own  country.     I  remember  once  trying  to 

10  145 


MEDICAL  EUROPE 


find  at  the  University  of  Pennsylvania  a  man 
famous  in  scientific  medicine  throughout  the 
world.  I  made  the  mistake  of  going  to  the 
University  Hospital  instead  of  to  his  labora- 
tory, which  is  a  building  or  two  removed, 
and  five  officials  had  to  be  called  in  rotation 
before  one  was  found  who  had  ever  heard 
of  the  eminent  gentleman. 


A    COLLKCTOR    OF    CiGAR    "  BdTTS  " 


However 
in  to  write 
daily  skin 
that  I  wish 
room  itself 
tables  and 
It  is  large 
crowd  into 


it  is  not  Sabouraud  that  I  started 
about  especially,  but  it  is  the  great 
clinic  of  the  Hospital  Saint  Louis 
to  attempt  to  picture.    The  clinic- 
is  high-posted  and  bare.     Three 
a  few  chairs  are  its  only  furniture, 
enough  for  a  hundred  people  to 
at  a  pinch,  though  the  adjoining 


146 


PARIS 

waiting-room  will  seat  six  or  seven  hundred. 
Into  this  room  pour  daily  from  three  or  four 
to  six  or  seven  hundred  patients — children 
first,  then  women,  then  men.  These  people 
know  what  is  expected  of  them.  The  children 
are  quickly  divested  of  clothing  and  brought 
naked  to  the  chair  of  the  examiner.  Usually 
there  are  three  examinations  going  on  simul- 
taneously, with  Gaucher,  or  De  Bourmann, 
or  whoever  is  on  service  at  that  particular 
time,  going  from  one  to  the  other  and  picking 
out  for  special  study  a  case  that  is  obscure. 
Behind  the  chairs  of  the  examiners  are 
grouped  the  eager  students,  among  whom 
will  be  found  men  from  all  over  the  world 
who  at  home  would  be  classed  not  as  students, 
but  as  eminent  skin  specialists. 

The  patients  are  disposed  of  with  light- 
ing rapidity.  A  quick  searching  look,  a  skilful 
moving  of  the  finger  over  the  lesion,  and  then 
a  green  card  here,  a  red  card  to  the  next,  a 
yellow  card  to  the  third,  with  perhaps  two 
words  scribbled  hastily  on  a  prescription 
blank,  serves  to  dispose  of  the  great  majority 
of  the  patients. 

The  room  is  quickly  cleared  of  children 
and  then  come  the  women.  Here  is  indeed 
the  whole  Comedie  Humaine  of  Balzac  com- 
pressed into  a  straggling  line  that  approaches 

147 


MEDICAL  EUROPE 

the  examiner.  Youthful  faces,  some  beauti- 
ful and  pure,  some  already  bearing  the  lines 
of  drink  and  debauchery.  Soft  eyes,  in  which 
the  tears  are  just  held  back;  hard  eyes,  meet- 
ing boldly  those  of  the  examiner  and  the 
crowding  students;  aged  faces,  reflecting  a 
thousand  vicissitudes  of  life.  On  they  come 
clasping  to  well-rounded  bosoms,  with  over- 
bejewelled  fingers,  dainty  ribboned  lingerie  of 
costly  lace;  clasping  to  flat  breasts,  with 
bony  talons,  tattered  shreds  of  dirty  unname- 
able  rags.  They  are  all  here— the  gay  beau- 
ties of  the  boulevards  and  of  the  "  BouV 
Mich. ";  the  bent  shape  of  a  woman  who  offers 
you  matches  before  the  steps  of  the  Made- 
leine; the  grisettes  of  the  shops  and  of  the 
factories,  and  respectable  wives  of  the  sub- 
merged— all  touching  naked  shoulders  in  this 
great  skin  clinic  of  the  Saint  Louis  Hospital. 
And  the  men!  To  describe  them  is  beyond 
my  pen.  Here  a  flushed  youth  suffering  the 
anguish  of  his  first  indiscretion,  holding  a 
shaking  hand  to  his  trembling  torso.  Next  a 
distinguished  looking  middle-aged  man  with 
gray  imperial,  who  guards  his  cuffs  and  false 
shirt-bosom  so  carefully  for  fear  of  soiling. 
Beside  him  a  "bum"  in  rags,  with  face  like 
sole  leather.  Then  an  artist,  or  perhaps  a 
musician,  to  judge  from  his  long  black  hair 

148 


PARIS 


i 


and  delicately  shaped  fingers.  Beside  him  a 
workman  with  brown  corduroy  trousers  tied 
up  with  a  red  sash.  All  are  here,  with  per- 
haps the  fear  of  the  same  dread  disease  staring 
at  them  from  the  purplish-red  papules  that 
blotch  their  skin.  For  syphilis  is  not  the  least 
frequent  of  the  lesions  that  come  to  this 
clinic.  This  disease  may  be  seen  in  almost 
any  of  its  multiform  manifes-  I  / 
tations,  some  of  which  are  V  *^^ 
hideous   to   look   upon.  Yl 

But  there  is  comedy  here, 
too,  for  many  of  these  skin 
lesions  are  comparatively  in- 
significant, and  the  patients 
seem  disappointed  that  it  is 
no  worse.  An  amusing  thing 
is  the  tattoo  marks  one  fre- 
quently sees  here.  In  the 
ecstasy  of  his  first  love  a  man  often  has  tat- 
tooed on  his  arm  a  large  heart  pierced  by  an 
arrow  and  above  the  name  of  his  adored  one, 
as,  for  example,  ''Marie  pour  la  m^. "  The 
course  of  true  love,  however,  is  evidently  not 
always  life  enduring,  notwithstanding  the 
tattooed  sentiment,  and  so  we  may  have  the 
"Marie"  eliminated  by  a  tattooed  line  and 
** Louise"  worked  in  above.  I  have  seen  as 
many  as  three  names  erased  in  this  manner 

149 


MEDICAL  EUROPE 

with  a  fourth  flourishing  in  a  quite  elevated 
manner  above  the  pour  la  vie. 

The  most  common  disease  one  sees  here 
is  la  gale,  the  common,  every-day  itch,  or 
scabies  as  we  term  it.  A  French  dermatologist 
can  spot  this  lesion  as  far  as  he  can  see  the 
patient,  and  the  quickness  with  which  these 
cases  are  glanced  at,  given  their  bath  card,  and 
hustled  away,  is  remarkable.  A  hundred 
such  cases  will  be  disposed  of  in  fifteen  min- 
utes at  this  clinic.  It  is  when  a  somewhat 
rare  or  obscure  lesion  appears  that  time  is 
consumed.  Then  there  is  something  doing. 
Every  physician  is  called,  every  student 
crowds  eagerly  forward.  The  patient  is 
passed  about  from  one  to  another  and  a 
voluble  discussion  arises.  It  is  hours  perhaps 
before  the  sufferer  regains  his  shirt  (or  her 
chemise)  as  the  case  may  be.  All  day  long 
the  patients  pour  into  this  clinic.  Not  only 
in  the  morning,  but  after  a  brief  respite  for 
lunch  there  are  as  many  more  waiting  as  were 
disposed  of  in  the  forenoon. 

I  came  out  of  a  morning  session  with  a 
graduate  of  one  of  the  largest  medical  institu- 
tions we  have  in  America.  ''By  Jove,"  he 
ejaculated,  "I've  seen  more  cases  of  skin  dis- 
eases this  morning  than  I  saw  in  all  my  four 
years  in  medical  school."     I  didn't  dispute  it, 

150 


PARIS 

but  intimated  that  if  he  would  follow  me  to 
the  Marguery,  I  would  introduce  him  to  a 
filet  de  sole  and  a  variety  of  aperitif  which  I 
was  sure  he  hadn't  encountered  between  clin- 
ics in  the  course  of  his  medical  education,  and 
which  would  take  the  taste  of  what  we  had 
seen  out  of  our  mouths. 


XIII. 

PARIS     CONTINUED IN    THE     LATIN    QUARTER 

SURGICAL    CLINICS 

"Je  I'appeir  ma  p'tit'  bourgeoise, 
Ma  Tonki,  ma  Tonki,  ma  Tonkinoise — 
Y  en  a  d'autr's  qui  m'  font  les  doux  yeux, 
Mais  c'est  ell'  que  j'aim'  le  mieux. " 

A  MODEL,  rather  a  pretty  girl  with  purple 
velvet  eyes,  was  humming  the  words  to  the  ac- 
companiment of  Schoemaker's  violin.  There 
were  other  girls,  also  with  attractive  eyes,  and 
with  big  drooping-brimmed  hats  from  which 
fluttered  attractively  long  lengths  of  fluffy 
veiling,  resting  frequently  on  masses  of  skil- 
fully coiffed  hair  of  wonderful  color,  sitting 
about  the  room.  Here  and  there  with  one  of 
the  girls,  could  be  seen  the  interesting  face  of 
a  youth  too  clean  shaven  to  be  other  than 
American.  For  we  were  at  Lavenue's,  on  the 
Boulevard  Montparnasse,  in  the  heart  of  the 
artist's  Latin  Quarter,  where  the  American 
art  students  most  do  congregate.  And  artists, 
even  though  American,  do  not  hesitate  to  ap- 
pear in  public  with  their  mistresses  (or  their 
friends'  mistresses)  to  drink  their  evening 
Bock.     Neither  do  prominent  American  sur- 

152 


PARIS 

geons  and  physiologists  absolutely  refuse  to 
come  to  Lavenue's  occasionally  on  a  summer's 
evening — not  to  see  the  models  of  course,  but 
merely  to  hear  the  music. 

"And  you  mean  to  tell  me,"  I  said  to  my 
friend,  a  chap  from  Chicago  who  had 
been   for   two    years    about   the    hospitals   of 


Paris,    "that    you    can   do   any  real  work   in 
this  environment?" 

"I'll  admit,"  he  replied,  "that  the  life  of 
the  cafes  does  get  into  one's  blood,  and  that 
after  the  seriousness  of  medical  courses  as 
they  are  given  in  Berlin  and  Vienna,  it  would 
be  a  bad  thing  for  a  man  to  come  to  Paris, 
if  he  really  wanted  to  do  any  heavy  work  in 
medicine.  But  there  is  work  enough  here,  and 
good  work.     The  chief  difficulties  are  in  find- 


MEDICAL  EUROPE 

ing  it  in  the  first  place,  and  then  buckhng 
down  to  it  after  you  have  found  it." 

And  that  is  the  whole  story  in  a  nutshell. 
As  I  have  previously  stated,  medicine  as  a 
business  proposition  is  not  organized  here  as 
it  is  in  Germany,  to  catch  the  golden  windfall 
of  American  dollars  by  short,  easily  obtain- 
able, convenient  courses,  that  one  can  take 
in  two  weeks  or  a  month  and  go  home  a 
"trained  specialist." 

In  Paris,  one  must  find  out  things  about 
medicine  for  himself.  There  is  some  of  the 
finest  work  being  done  in  medicine  in  Paris 
that  is  to  be  found  anywhere  in  the  world. 
And  there  are  no  better  men  anywhere  to 
work  with  than  here.  But  you  must  get  into 
almost  everything  as  the  guest  of  the  instruc- 
tor, and  this  is  not  always  an  easy  thing  to  do. 
To  begin  with,  a  man  must  know  how  to  speak 
French.  One  can  study  medicine  in  Ger- 
many without  a  knowledge  of  German,  but 
one  cannot  study  medicine  in  Paris  without 
a  knowledge  of  French. 

First  of  all  one  should  go  to  a  medical  book- 
store and  get  a  copy  of  ''  Hbpitaux  et  Hospices 
de  Paris,  Composition  des  Services/'  which 
details  a  list  of  all  the  hospitals  of  Paris  and 
all  the  men  in  these  hospitals  from  the  chiefs 
of  clinic  down  to  the  externes.     It  is  well  also 

154 


PARIS 

to  go  to  L' Assistance  Puhlique  and  get  a  card, 
which  will  admit  you  anywhere,  although  this 
card  is  seldom  necessary.  Then  you  can  pick 
out  your  hospital  and  your  man,  and  do 
practically  any  work  you  desire,  and  this 
usually  as  a  colleague,  entirely  free  of  cost. 
There  is  also  the  Ecole  de  Medecine,  where 
one  can  take  laboratory  courses  of  any  sort, 
regular  or  specially  arranged.  There  is  prob- 
ably no  better  place  in  the  world  for  a  man  to 
learn  the  fine  points  of  anatomy  than  right 
here.  Plenty  of  instruction  can  be  obtained 
for  a  very  reasonable  fee. 

Another  thing  a  man  should  know  about  in 
coming  to  Paris  is  the  Ainerican  Art  Student's 
Association  at  No.  74  Rue  Notre  Dame  des 
Champs.  Here  are  always  to  be  found  a 
bunch  of  good  fellows,  mostly  artists,  who,  if 
you  are  a  scholar,  a  gentleman,  a  good  sport, 
and  have  an  artistic  temperament  and  the 
literary  touch  (and  haven't  too  much  money), 
will  see  that  your  name  is  put  up  for  member- 
ship. If  you  lack  all  the  above  qualities,  take 
a  plug  of  good  old  American  chewing-tobacco 
over  with  you  and  you  will  be  made  a  member 
even  with  greater  rapidity  than  on  the  first 
count.  The  dues  of  the  club  are  something 
like  thirty  francs  (six  dollars)  a  year.  The 
Art    Student's    Club    certainly    brings    back 

155 


MEDICAL  EUROPE 

memories  of  many  pleasant  evenings,  and  I 
wish  I  could  adequately  express  my  appre- 
ciation to  "Dutch"  Goetsch,  "Moskie," 
''Heine,"  and  all  the  rest  of  the  fellows  who 
were  so  good  to  such  a  rank  outsider  as 
myself. 


A'lsn'K  A  i/IIdPiTAL  (Lvxembovkg) 

But  to  return  to  our  mutton,  as  the  French 
say.  What  can  an  American,  one  who  is 
over  for  a  short  time  only,  or  one  who  has 
been  working  hard  in  Germany  for  a  year, 
do  in  medicine  while  in  Paris  to  make  his 
visit  profitable?     In  Paris  one  is  pretty  well 

156 


PARIS 

contented  to  loaf;  more  so  than  in  any  other 
city  in  the  world,  I  believe,  but  afternoons 
and  evenings  are  quite  sufficient  for  the 
"sights,"  the  cafes,  and  the  boulevards,  and 
it  is  well  to  put  in  the  mornings  visiting  clinics ; 
all  of  which  are  open  to  any  one,  provided  he 
can  find  them. 

In  surgery  for  instance  there  are  a  number 
of  good  men  to  see.  First  of  all  there  is  Pozzi, 
as  well  known  in  America  perhaps  since  his 
trip  over  here,  as  any  of  the  French  surgeons. 

Strictly  speaking,  I  should,  of  course,  refer 
to  Pozzi  as  a  gynaecologist,  but  I  take  the 
liberty  of  including  operations  of  various 
sorts  under  surgery.  Pozzi  is  to  be  found  at 
the  Broca  Hospital.  This  is  a  cosily  situated 
institution  of  moderate  size,  tucked  away  a 
little  to  the  south  of  the  noise  of  the  Latin 
Quarter.  The  first  thing  that  strikes  one 
in  walking  through  the  wards  of  the  Broca 
are  the  extensive  and  ornate  mural  decora- 
tions. These  were  all  painted,  so  I  under- 
stood, by  grateful  patients,  and  some  of  them 
are  not  bad.  No  worse,  at  least,  than  the 
Chavannes  frescoes  in  the  Boston  Public 
Library,  remarked  a  man  from  Boston  who 
was  walking  through  the  hospital  with  me. 

Pozzi's  operating-room  is  small,  and,  in 
order  that  a  considerable  number  of  men  can 

157 


MEDICAL  EUROPE 

see  a  given  operation,  a  sort  of  gallery  has 
been  erected  on  one  side  of  the  room.  You 
put  on  a  (once)  sterile  gown  in  a  side  room 
and  walk  up  a  flight  of  stairs.  Then  you  turn 
and,  voila !  you  find  yourself  on  a  sort  of 
balcony  with  the  gory  field  directly  below  you. 
Pozzi  himself  is  a  rather  stout  man  with 
swarthy  black  whiskers,  and  if  you  introduce 
yourself  to  him  he  receives  you  most  kindly. 
His  balcony  scheme  is  all  right,  only  it  em- 
barrasses one  to  look  down  and  note  that  the 
assistants,  the  nurses,  the  anesthetist,  and  the 
attendants  are  all  staring  up  at  you  instead  of 
paying  attention  to  their  own  business.  But 
Pozzi  doesn't  seem  to  mind,  or  else  he  is 
used  to  it,  for  without  comment  he  doubles 
across  the  table  in  his  endeavors  to  reach  an 
instrument  extended  towards  nowhere  by  a 
languid  assistant,  who,  to  judge  from  the 
direction  of  his  gaze,  is  interested  in  the 
neckties,  or  perhaps  the  American  shoes,  of 
those  on  the  balcony. 

Another  surgeon  who  is  well  spoken  of  in 
Paris  is  Delbet,  who  operates  at  the  Laennec 
Hospital,  near  the  Bon  Marche.  Delbet  is  a 
middle-aged  man,  deliberate  in  speech  and 
action;  remarkably  so  for  a  Frenchman. 
Nothing  jars  him  in  the  least.  For  instance, 
one  day  when  I  was  there,  he  happened  to  cut 

158 


PARIS 

the  ureter  in  taking  out  a  large  ovarian  cyst. 
He  made  no  remark,  however,  nor  scarcely  a 
sign  save  the  slight  raising  of  the  eyebrows, 
and  went  on  and  did  an  end-to-end  anasto- 
mosis as  though  it  were  a  part  of  the  opera- 
tion. While  not  a  rapid  operator  his  technic 
is  finished,  and  as  a  consultant  his  word  is  of 
as  great  weight  as  that  of  any  man  in  Paris. 

While  Delbet  has  no  balcony  to  interest 
you,  you  can  amuse  yourself  by  watching  his 
assistants  wash  up.  He  operates  in  a  large 
room,  the  upper  end  of  which  only  is  used 
for  the  operation.  Down  the  middle  of  this 
room,  for  its  whole  length,  is  a  long  table  on 
which  is  a  tremendous  array  of  wash-basins 
filled  with  fluids  of  various  colors,  yellow 
predominating.  While  waiting  for  the  patients 
to  be  brought  in,  the  assistants  amused 
themselves  by  washing  their  hands  in  these 
various  basins.  I  tried  to  keep  count  of  the 
number  of  times  each  man  washed,  but  as  I 
started,  unfortunately,  to  think  in  French,  my 
numerals  were  exhausted  before  a  man  got 
half  way  down  the  line. 

I  promised  myself  a  special  treat  one  morn- 
ing. I  would  go  to  see  Faure,  whom  I  had 
heard  called  the  most  skilful  surgeon  in  Paris; 
"the  man  who  did  a  hysterectomy  in  two 
minutes. "    I  went  to  see  Faure,  and  undoubt- 

159 


MEDICAL  EUROPE 

edly  he  is  a  clever  operator,  the  best  by  all 
means  that  I  saw  in  France.  He  did  a  hyster- 
ectomy that  morning,  and  did  it  beautifully, 
but  not  in  two  minutes — not  by  something 
over  an  hour. 

Here  at  the  little  Hospital  Cochin  is  also 
to  be  found  Widal,  the  man  who  made  agglu- 
tination famous.  And  one  can  vary  a  fore- 
noon by  making  a  ward  visit  with  him.  The 
Cochin  is  a  small  hospital,  and  new  wards  are 
in  process  of  construction,  so  one  should  not 
criticise  things  one  finds  there  too  severely. 
But  the  ward  which  Widal  has  in  charge,  as 
it  is  at  present,  is  pretty  bad  even  for  tem- 
porary quarters.  It  is  a  long,  low,  one-story 
wooden  building,  hardly  such  a  place  as  one 
would  expect  to  find  presided  over  by  a  man 
as  famous  all  over  the  civilized  world  as  is 
Widal.  And  Widal's  laboratory  is  even  worse 
than  the  ward.  I  will  spare  the  details. 
Strangely  enough,  it  is  under  just  such  diffi- 
culties that  the  best  work  in  medicine  has  as 
a  rule  been  done,  and  Widal  is  still  delivering 
the  goods. 

It  is  at  the  Cochin,  also,  that  on  certain 
evenings  one  can  see  the  famous  Lues  Line, 
a  long  string  of  men  reaching  out  into  the 
Rue  du  Fauborg  St.  Jacques,  waiting  their 
turn  for  their  mercury  injection.    The  "Bread 

160 


?> 


n 


-n 


PARIS 

Line"  of  New  York  has  been  made  famous, 
both  by  story  and  })y  j>Icture,  })ut  tlie  disease 
til  at  has  given  rise  to  the  Lues  Line  at  the 
Cochin  is  too  common  in  Paris  to  excite  the 
pen  or  the  brush  of  story-teller  or  painter. 

So  it  is  that  one  can  pass  any  number  of 
mornings  in  this  way,  going  about  from  clinic 
to  clinic.  I  should,  of  course,  speak  of 
Albarran,  the  great  specialist  in  maladies  du 
voies  urinaires,  who  has  the  only  real  operat- 
ing amphitheatre  in  Paris.  The  larger  places, 
such  as  the  Hotel  Dieu  and  the  Salpetriere, 
1  Piave  also  omitted  as  one  would  more 
naturally  find  such  places  for  oneself.  Espe- 
cially should  one  see  Babinski's  clinic  at  the 
Salpetriere,  for  with  the  possible  exception  of 
Widal  and  Fournier,  Babinski  is  the  best- 
known  practitioner  of  medicine  in  Paris,  and 
it  is  a  liberal  education  in  itself  to  see  him 
extract  his  own  reflex  in  the  proper  manner, 
which,  by  the  way,  the  average  practitioner 
rarely  does. 

Then  the  beauty  of  it  all  is  that  after  you 
have  salved  your  conscience  with  your  morn- 
ing visit  to  one  of  these  places,  there  are  in 
a  thousand  attractive  restaurants  a  delicious 
lunch  awaiting  you. 

If  you  are  not  a  bloated  plutocrat  with  a 
taste  and  a  pocket-book  for  Foyot's  or  Mar- 
ios 


MEDICAL  EUROPE 

guery's,  and  have  been  to  the  Broca  or  the 
Cochin,  I  should  advise  you  to  drop  into 
Garnier's,  on  the  Boulevard  Raspail,  which 
is  near,  and  see  how  cheaply  you  can  lunch 
well  in  Paris.  You  need  not  spend  over  a 
franc  or  a  franc  and  a  half  here  at  the  most, 
and  it  is  left  to  your  honesty  to  go  inside  when 
you  have  finished  and  tell  the  lady  at  the 
counter  how  many  sous'  worth  you  have  eaten. 
And  if  you  are  coming  again,  the  lady  will  put 
your  napkin  away  for  you  (but  only  for  a 
week) ,  and  you  can  save  two  sous  thereby.  It 
is  worth  saving,  for  with  that  two  sous  you  can 
buy  a  delicious  cup  of  coffee  on  the  corner, 
at  the  '* Little  Dome,"  just  opposite  the  ''Big 
Dome"  where  the  American  artists  and  story- 
writers  play  poker. 

And  in  the  evening  there  is  Lavenue's 
ap'ain,  and  the  artists  and  their  models  and 
the  music,  and  the  pretty  girl  with  the  purple 
velvet  eyes  may  finish  the  song: 

"Dans  mon  coeur  j'  garderai  toujours 
Le  souv'nir  de  nos  amours." 


XIV. 

PARIS    CONTINUED THE    PASTEUR    INSTITUTE 

METCHNIKOFF. 

It  was  raining  the  morning  I  started  out 
for  the  Pasteur  Institute,  and  instead  of 
cHmbing  to  the  top  of  an  omnibus,  as  usual, 
I  took  a  seat  inside.  I  did  not  know  that  the 
fare  was  twice  as  much  for  riding  inside  as 
it  was  for  riding  outside,  and  in  consequence 
I  had  a  long  and  spirited  argument  with  the 
conductor,  which  ended  in  my  paying  fifteen 
centimes  more  than  I  thought  I  should  have 
paid.  Therefore  I  arrived  at  the  gate  of  the 
Institute  as  mad  as  the  collection  of  dogs 
that  were  howling  in  the  little  building  at  the 
right  of  the  entrance. 

As  to  buildings,  the  Pasteur  Institution 
does  not  impress  one  greatly.  It  is  the  thought 
of  what  one  man  can  do;  the  thought  of  the 
hundreds  of  research  institutions  that  have 
been  erected  in  every  civilized  country  just 
because  Louis  Pasteur  lived  and  worked,  that 
makes  you  take  off  your  hat  as  you  go  up  the 
steps  of  the  old  Institut  Bacteriologique. 

Inside  there  is  nothing  particularly  striking. 
There  are  a  number  of  large  rooms,  in  some 

165 


MEDICAL  EUROPE 

of  which  men  may  be  seen  at  a  desk  before  a 
microscope,  or  examining  a  test-tube.  There 
is  a  Ubrary  in  which  you  may  see  some  one 
quietly  studying  one  of  the  volumes  that  fill 
the  shelves  about  the  room.  There  are  rooms 
in  which  rabbits  and  guinea-pigs,  in  well-kept 
cages,  nibble  at  carrots  and  oats  contentedly. 
You  will  be  shown  a  tomb,  and  be  told  that 


PaSTFAIR   IxSTlTrTE 


here,  in  the  place  where  he  lived  and  worked, 
Louis  Pasteur  sleeps.  Nothing  about  all  this 
to  interest  the  Cook's  tourist  who  is  seeing 
Europe  in  thirty  days,  and  Paris  in  forty- 
eight  hours.  Why,  over  in  the  right  bank  of 
the  Seine  is  a  much  more  impressive  tomb, 
built  for  that  Napoleon  chap,  grand  in  pro- 
portion to  his  rabid  life.  Moreover,  there  are 
the  crypts  of  the  Pantheon.     One  can  see  a 


16G 


PARIS 

whole  bunch  of  sarcophagi, — Hugo,  Voltaire, 
Rousseau,  Carnot, — all  in  fifteen  minutes,  and 
so  much  time  saved. 

But  for  a  man  whose  life  is  wrapped  up  in 
medical  science  and  who  feels  so  keenly,  in 
the  light  of  the  mean,  insignificant  little  work 
that  he  has  done,  what  it  means  to  be  a  great 
man  in  medicine,  there  is  no  greater,  higher 
privilege  than  to  pay  one's  respects  to  the 
honored  ashes  of  such  a  man  as  was  Pasteur. 

Pasteur,  a  modest,  simple,  quiet  little  man 
who,  I  am  quite  sure,  must  have  been  fre- 
quently insulted  by  his  concierge  and  his 
cpicicr,  as  all  great,  but  modest,  men  are; 
Pasteur,  who  had  neither  palace  at  Versailles 
nor  chateau  at  Fontainebleau.  His  palace 
was  a  narrow  room  filled  with  test-tubes  and 
chemicals,  and  his  life  was  a  striking  reverse 
to  the  medallions  that  bore  on  the  obverse 
the  likeness  of  Louis  XIV  and  of  Napoleon. 

We  are  appalled  when  we  read  of  the 
enormous  sums  of  money  that  were  spent, 
and  thousands  of  lives  that  these  latter  men 
sacrificed,  either  directly  or  indirectly.  But 
do  we  sufficiently  realize  that  this  simple, 
modest  scientist,  Louis  Pasteur,  saved  to  the 
ao'riculturists  of  France,  bv  his  work  on  dis- 
eases  of  wines  and  of  silk-worms,  more  mil- 
lions than  these  men  and  all  their  kind  took 

167 


MEDICAL  EUROPE 

from  the  people,  and  saved  more  lives  than  the 
French  Revolution  and  the  wars  of  Napoleon 
cost!     Pasteur  sleeps,  but  his  work  goes  on. 

The  Pasteur  Institute  was  made  possible 
by  an  international  subscription  started  by 
V Academie  des  Sciences^  by  which  a  sum  of 
2,500,000  francs  was  raised.  The  present 
service  was  inaugurated  the  18th  of  Novem- 
ber, 1888.  This  was  after  Pasteur's  study  on 
rabies  had  created  a  demand  for  his  treat- 
ment that  had  resulted  in  his  old  laboratory 
in  the  Rue  d'Ulm  becoming  wholly  inade- 
quate for  the  patients  who  came  to  him  for 
anti-rabic  inoculation. 

In  1894  the  communication  of  Dr.  Roux 
on  the  treatment  of  diphtheria  by  the  serum 
of  Behring  and  Kitasato  again  aroused  public 
sentiment  in  regard  to  serum  therapy,  and  a 
second  subscription,  started  by  the  Figaro, 
resulted  in  a  large  sum  by  which  additional 
buildings  were  built  sufficient  to  immunize  a 
large  number  of  horses  for  obtaining  anti- 
diphtheria  antitoxin.  A  hospital  of  100  beds 
was  made  possible  by  the  donation  of  a  million 
francs  from  a  friend  of  the  Institute,  and 
later  the  contribution  of  Baron  Hirsch  made 
possible  the  erection  of  the  physiological 
chemistry  institute  on  the  Rue  Dutot. 

The  name  Pasteur  Institute  has  also  legiti- 

168 


Pasteuk 


PARIS 

mately  been  given  to  other  institutions  in 
different  parts  of  the  workl,  where  pupils  of 
le  Maitre  (as  Pasteur  is  always  referred  to 
here)  have  been  installed  to  give  the  Pasteur 
treatment  against  rabies.  At  Lille  is  Dr. 
Calmette;  at  Constantinople  is  Dro  Nicolle; 
at  Tunis,  Dr.  Loir. 

The  personnel  of  the  Institute  is  divided 
into  services.  First  is  the  service  des  vaccins, 
directed  by  Dr.  Chamberland.  Here  are 
prepared  vaccines  against  anthrax,  hog  chol- 
era, and  glanders;  and  here  also  tuberculin 
is  prepared.  The  second  service  is  the  ser- 
vice de  la  rage,  the  purpose  of  which  is  to 
prevent  the  people  bitten  by  mad  dogs  from 
becoming  themselves  the  victims  of  hydro- 
phobia. This  service  is  under  the  direction 
of  Dr.  Grancher.  Since  the  end  of  1885  more 
than  23,000  persons  have  submitted  for  anti- 
rabic  treatment  in  this  place.  The  mortality 
of  those  treated  is  less  than  five  in  each  thou- 
sand. Before  this  treatment  was  instituted 
fifteen  out  of  each  hundred  persons  bitten  by 
mad  dogs  died. 

Dr.  Roux  is  head  of  the  service  de  la  microhie 
technique.  Two  courses  in  bacteriology  are 
given  here  each  year;  the  first  in  November- 
December,  the  second  in  February-March. 
These    courses    are   open   to   Americans,    but 

171 


MEDICAL  EUROPE 

application  for  a  place  should  be  made  some 
time  in  advance,  for  the  number  of  men  in 
the  course  is  limited. 

The  fourth  service  is  called  the  service  de  M. 
Metchnikoff.  Here  are  found  the  men  engaged 
in  original  research — research  that  covers  a 
wide  range  of  medical  thought,  and  has  been 
of  the  greatest  service  to  mankind.  Mesnil, 
Besredka,  Laveran  (the  discoverer  of  the  mala- 
ria Plasmodium)  and  other  great  men  are  found 
working  at  the  benches  in  this  department. 

The  Chemical  Institute  we  are  taken  across 
the  street  to  see.  If  we  are  fortunate,  Jupille 
himself  may  be  our  guide  and  may  point  out 
to  us  the  bronze  statue  representing  his  own 
struggle  with  a  mad  dog.  Jupille  has  the 
honor  of  being  the  only  concierge  in  Paris  who 
has  his  own  statue  within  the  portal  which  he 
guards.  At  the  Chemical  Institute  we  visit 
first  the  laboratories  of  Etard  and  Bertrand, 
which  are  used  only  for  research  work.  But 
here  are  also  the  teaching  laboratories  in 
charge  of  Professor  Duclaux.  The  course  in 
bio-chemistry  was  transferred  here  from  the 
Sorbonne  in  1889,  and  here  are  given  courses 
in  practical  analysis  of  physiologic  and  patho- 
logic products.  A  number  of  Americans 
have  availed  themselves  of  the  opportunity 
offered  for  work  here. 

172 


y... 


¥■ 


Chemistry  Institute 


PARIS 

I  liad  no  letter  of  introduction  to  Metchni- 
koff,  but  he  received  me  most  graciously.  He 
is  a  fine  physical  tyj)e  of  man  and  most  genial. 
He  wears  long  hair  and  a  beard.  Both  are 
well  streaked  with  gray.  He  impresses  you 
as  a  strong  man  both  mentally  and  physically. 

The  career  of  Metchnikoff  has  been  an 
interesting  one.  He  was  born  in  Russia,  sixty- 
two  years  ago.  It  was  in  Russia  that  he 
received  his  preliminary  schooling,  but  his 
advanced  study  he  did  in  Germany.  In  1870, 
when  twenty-five  years  of  age,  he  went  back 
to  Odessa  to  take  the  chair  of  Zoology.  He 
had  done  the  ordinary  things  well.  The  great 
things  came  twelve  years  later.  In  1882,  at 
Messina,  he  made  the  first  observations  that 
have  led  to  the  most  brilliant  and  interesting 
chapter  that  we  have  in  pathology;  phagocy- 
tosis. This  conception  of  battle  between  the 
white  blood  corpuscles  and  bacteria  has  been 
one  of  the  most  dramatic  pictures  in  the  whole 
history  of  medicine. 

This  discovery  came  at  a  most  opportune 
time.  Virchow  had  established  the  impor- 
tance of  the  cell.  Pasteur  had  discovered  the 
invading  microbe.  Metchnikoff  linked  the 
two.  It  was  natural  that  such  a  man  was 
needed  in  medicine,  and  Pasteur  called  Metch- 
nikoff   to    Paris    in    1888.     The   rest   of   the 

175 


MEDICAL  EUROPE 

story  we  know.     Every  medical  man  is  famil- 
iar with  Metchnikoff's  two  great  works — the 
first,  on  Inflammation;    the  second,  on  Im- 
munity.   And  his  later  work,  "The  Nature  of 
Man,"  is  widely  read  outside  of  medical  circles. 
When    Metchnikoff    went    to    work    on    a 
scientific  study  of  old  age,  based  on  funda- 
mental  principles   of  phagocytosis,   the   Ger- 
man scientists  said  he  was  crazy.     They  were 
wrong.       Metchnikoff    had    attacked    a    big 
problem.      No   one   realized   that  fact   better 
than  himself,  for  he  was  no  fanatic  seeking 
a  life  elixir.     When  he  kept  at  his  side  in  the 
laboratory  a  bowl  of  yoghurt,  from  which  he 
drank  occasionally,   he  had   a  reason  for  it. 
In  this  sour  milk  were  bacteria  which  he  con- 
sidered would  "do  things"  to  the  flora  of  his 
gastro-intestinal    tract    that    were    trying    to 
hand  his  arteries  a  lemon.     And  we  use  the 
term  "lemon"   advisedly,  for  the  body  may 
be    compared    to    that    much-maligned    fruit, 
which  consists  of  pulp  and  juice.     When  we 
are  young  we  are  "full  of  juice."     Old  age  is 
the  replacement  of  juice  by  fiber.     Just  as  a 
fruit  goes  "woody,"  so  in  old  age  the  paren- 
chyma of  the  liver,  kidneys,  and  other  organs 
is  replaced  by  fibrous  stroma.     We  know  that 
the   yeast   germs   in   wines,    beer,    and    other 
liquors  help  this  process  along.     "Why  not," 

176 


PARIS 

says  Metchnikoff  *' combat  these  organisms 
by  introducing  bacteria  of  an  opposite  sort?" 
However,  Metchnikoff  merely  amuses  him- 
self with  these  things.  While  all  this  old-age 
talk  and  "craziness  of  the  good  old  man" 
was  circulating,  Metchnikoff  had  been  busy- 


Metciixikdff 


ing  himself  with  studies  in  ape  inoculation 
with  syphilitic  virus,  and  found  that  the 
chimpanzee  was  susceptible  to  this  disease 
and,  moreover,  that  inoculations  could  be 
carried  from  animal  to  animal  of  the  same 
species,  but  with  decrease  of  virulence.  So  that 
an  ape  could  be  rendered  immune  to  syphilis. 

12  177 


MEDICAL  EUROPE 

Theoretically  this  gives  us,  then,  a  method 
of  vaccination  against  syphilis  akin  to  the 
Pasteur  method  of  treating  rabies,  and  Metch- 
nikoff  suggests  that  all  prostitutes  step  up  and 
protect  themselves  from  the  danger  of  this 
disease,  which  is  an  almost  certain  accom- 
paniment of  their  trade. 

It  was  too  bad  that  Metchnikoff  did  not 
discover  the  spirochetce  pallida.  He  had  the 
chance,  considering  the  work  he  was  doing  at 
the  time  that  Schaudin  published  his  famous 
article.  It  should  have  been  Metchnikoff  who 
gave  the  cause  of  syphilis  to  the  world.  What 
a  great  and  fitting  climax  to  the  life  work  of 
this  great  man  that  would  have  been! 

I  left  Metchnikoff,  after  seeing  his  syphil- 
ized  apes,  and  being  presented  with  slides  of 
the  spirochetse  from  the  same,  without  tasting 
his  yaghurt.  I  was  afraid  that  if  I  took  any 
I  might  mix  up  with  that  omnibus  conductor 
provided  I  met  him  on  the  way  home,  for  I 
was  still  sore  about  my  fifteen  centimes. 

'  Paris  is  an  interesting  city  at  night,  perhaps 
the  most  attractive  in  all  the  world.  One 
dines  in  a  brilliantly-lighted  restaurant  filled 
with  beauty  and  with  the  laughter  and  vivac- 
ity that  come  from  a  mingling  of  perfectly 
groomed  men  and  decollete  women  who  have 

178 


PARIS 

forgotten  all  save  wine  and  soul  and  freedom. 

After  such  a  dinner  one  likes  to  light  a 
cigarette  and  with  cordial  and  coffee  listen 
to  the  music  that  is  always  good  in  such  a 
place  and  dream  of  the  pure  joy  of  life. 

But  the  evening  after  my  visit  to  the  Pas- 
teur Institute  I  was  not  content.  The  dinner 
had  been  perfect.  I  had  my  cordial  and 
coffee  before  me,  and  an  artist  of  the  violin 
was  playing  Gounod's  ''Ave  Maria,"  but  I  was 
uneasy.  The  night  attracted  me,  and  I  walked 
out  on  to  the  Avenue  de  1' Opera.  It  was  a 
perfect  balmy,  moonlight  evening.  Down  the 
Avenue  was  the  obelisk  that  marked  the 
historic  Place  de  la  Concorde.  In  the  distance 
rose  the  Eiffel  tower,  a  huge  giant  of  the 
night.  I  did  not  know  where  I  was  going, 
but  I  called  a  voiture  and  told  the  cocker  to 
drive  me  down  the  Avenue.  Then  I  kept  on; 
I  crossed  the  Seine,  and  drove  on  through  the 
long  deserted  streets  that  lie  west  of  the  Latin 
Quarter  until  I  came  to  the  two  large  build- 
ings that  I  had  visited  that  morning.  I  bade 
the  cocker  stop,  and  I  sat  silently  and  won- 
dered at  the  genius  of  the  modest  little  man 
that  had  made  possible  all  that  those  buildings 
represented  throughout  the  civilized  world. 
Then,  through  the  deserted  streets,  I  drove 
back  to  the  midnight  noon  of  the  boulevards. 

179 


XV. 

LONDON SIR    A.    E.    WRIGHt's    LABORATORY 

PURSUIT  OF  THE  OPSONIC  INDEX. 

There  would  be  no  fun  going  abroad  un- 
less a  man  got  "  stung"  occasionally,  if  only  to 
have  the  experience  to  relate  after  getting  back 
home.  I  got  mine  in  London.  Some  one  had 
given  me  the  address  of  a  lodging-house  in 
Bloomsbury  Square  which  he  said  was  fine. 
Arriving  late  in  the  evening,  I  found  that  the 
place  was  "full  up,"  and  the  girl  at  the  door 
in  answer  to  my  enquiry  pointed  out  another 
house  down  the  street,  to  which  I  went.  I 
will  spare  the  gentle  reader  the  horrors  of 
that  London  lodging-house,  but  if  he  has 
been  in  London  he  can  fill  them  in  for  him- 
self, for  I  am  not  the  only  one  who  has  thus 
suffered. 

Perhaps  it  was  this  lodging-house  experi- 
ence that  prejudiced  me  against  London  to 
begin  with ;  or  perhaps  it  was  because  I  never 
struck  anything  save  cold  and  rainy  weather 
there;  or  perhaps  it  was  because  I  missed  the 
out-of-doors  cafes  of  Paris  and  Berlin;  or 
perhaps  it  was  because  I  didn't  understand 
the  languagCo     I  asked  a  man  one  day  how 

180 


LONDON 

to  get  to  "  Ludgate-Hill. "  After  some  ex- 
change of  words,  a  light  suddenly  dawned 
on  him  and  he  exclaimed,  "Oh,  I  see;  you 
want  Lugget'll, "  whereupon  the  congestion 
of  traffic  incident  to  the  discussion,  was 
relieved.  Anyway,  at  present  I  feel  as  though 
London  were  no  place  for  me.  If  ever  I  get 
rich  or  famous,  so  that  I  can  live  at  the  Ritz 


BLODMSEtTRY    SQUARE 


and  have  a  card  to  the  Carleton  Club,  and  a 
box  at  the  opera,  and  be  invited  to  meet  the 
royal  family,  I'm  going  back  and  give  the 
place  a  fair  try.  But  I'm  not  going  till  then. 
And  this  is  where  London  differs  from  the 
other  great  European  capitals.  In  Berlin  and 
in  Paris  you  don't  want  to  be  rich,  and  if 
you  think  of  prosperity  at  all,  it's  in  the  same 
terms   that   Harvard   thinks   of  Yale.      (The 

181 


MEDICAL  EUROPE 

exact  expression  used  to  be  printed  on  the 
stationery.)  In  Berlin  and  in  Paris  you  are 
perfectly  contented  with  things  just  as  they 
are,  and  pity  the  misguided  American  mil- 
lionaire who  stays  at  the  swell  hotels  and 
never  knows  the  joys  of  cheap,  but  eminently 
respectable,  student-pensions,  and  the  good 
hearts  of  those  you  find  there.  In  London, 
on  the  contrary,  you  cannot  help  associating 
poverty  with  dirt  and  ignorance. 

But  all  of  this  has  nothing  to  do  with  medi- 
cine, and  London  is,  in  truth,  one  of  the 
greatest  medical  centres  in  the  whole  world. 
I  fear  we  do  not  know  enough  of  the  great 
work  that  is  being  done  here.  Of  course  the 
more  popular  medical  advances,  such  as 
Wright's  opsonic  work,  come  to  us  very 
quickly,  but  there  is  a  lot  of  much  more 
truly  scientific  work  being  done,  that  we  do 
not  know  about  because  the  articles  describ- 
ing it  are  buried  in  society  bulletins,  hospital 
and  laboratory  reports,  and  what  not,  that 
we  never  hear  of.  German  and  French  scien- 
tific publications  are  so  easy  of  access  that  we 
can't  help  reading  them,  and  we  give  these 
latter  people  a  credit  for  leadership  in  certain 
lines  of  thought,  which,  perhaps,  they  do  not 
deserve.  On  the  other  hand,  all  that  relates 
to   medical   and  surgical  teaching — the  great 

182 


LONDON 

hospitals,  medical  museums,  and  laboratories, 
are  wide  open  in  London  and  you  have  but 
to  walk  in  and  help  yourself.  London  is  so 
big  that  you  can  scarcely  list  the  more  im- 
portant institutions,  much  less  go  into  detail 
concerning  them.  There  are  over  twenty- 
five  free  hospitals  of  considerable  size,  where 
you  can  get  instruction.     The  principal  hos- 


pitals, with  medical  schools  attached,  are  as 
follows — I  hope  the  information  is  correct. 
I  have  never  been  to  any  of  them.  I  was  too 
busy  trying  to  explain  to  a  tailor,  to  whom 
I  was  foolish  enough  to  give  an  order,  how 
an  American  desired  his  clothes  to  fit: — 

St.  Bartholomew's  is  on  the  edge  of  the 
City,  and  easily  reached  from  all  parts  of 
London.  The  hospital  contains  744  beds. 
The    library    and    the    physical    science    and 

183 


MEDICAL  EUROPE 

bacteriological  laboratories  have,  now,  at  their 
side,  a  very  large  building  which  includes 
club-rooms  for  the  Student's  Union,  a  writing- 
room,  and  luncheon  and  dining  halls. 

Charing  Cross  is  situated  in  the  very  centre 
of  London,  and  gives  instruction  in  all  sub- 
jects of  the  medical  and  dental  curriculum. 
The  Hospital,  with  its  Convalescent  Home 
at  Limpsfield,  contains  287  beds. 

St.  George's,  an  institution  with  248  beds, 
is  at  Hyde  Park  Corner.  The  school  pos- 
sesses an  Amalgamation  Club,  with  well- 
fitted  reading,  smoking,  and  luncheon  rooms, 
on  the  hospital  premises. 

Guy's  contains  602  beds.  Thirty-one  beds 
are  set  apart  for  diseases  of  the  eye,  and  40 
for  the  most  urgent  and  interesting  medical 
cases,  which  form  the  subjects  of  the  weekly 
clinical  lectures.  There  is  a  special  ward  of 
32  beds  for  the  treatment  of  diseases  of 
women,  and  for  cases  of  difficult  labor.  The 
new  Gordon  Museum  of  Pathology  is  worthy 
of  note. 

King's  College  has  220  beds  in  daily  use. 

The  London,  which  contains  914  beds,  is 
in  Mile  End  Road,  Whitechapel.  All  the 
arrangements  are  very  complete  and  modern. 
The  new  departments  of  Bacteriology,  Public 
Health,    Chemistry,    and    Biology,    the    new 

184 


LONDON 

Patliological  Institute  at  the  Hospital,  and 
new  Out-Patient  and  Special  Departments, 
have  been   added  within  the  last  few  years. 

The  Middlesex  is  in  Mortimer  Street,  W., 
and  close  to  Oxford  Street  and  Portland 
Place.  The  Hospital  contains  340  beds.  A 
wing,  containing  40  beds  and  special  labora- 
tories, is  entirely  devoted  to  patients  suffering 
from  cancer.  It  offers  unrivalled  opportuni- 
ties for  the  study  of  this  disease,  both  in  its 
clinical  and  pathological  aspects.  In  addition 
to  the  arrangements  for  teaching  ordinary 
students  all  subjects  of  the  medical  curricu- 
lum, a  bacteriological  and  public  health  lab- 
oratory has  been  added  for  the  purpose  of 
providing  instruction  for  women  desirous  of 
carrying  out  research  work  in  Public  Health, 
Bacteriology,   and  General  Pathology. 

St.  Thomas's  is  facing  the  Houses  of  Par- 
liament, and  forms  one  of  the  well-known 
architectural  features  of  London.  A  large 
library  and  reading-room  and  a  very  com- 
plete museum  are  open  to  all.  The  Hospital 
contains  605  beds,  and,  in  addition  to  the 
ordinary  provisions  of  a  great  hospital,  has 
connected  with  its  Out-patient  Department 
two  large,  well-ventilated  clinical  theatres 
provided  with  ample  sitting  accommodation, 
so  that  large  numbers  of  students  are  enabled 

185 


MEDICAL  EUROPE 

to   follow   closely   the   practice   and   teaching 
of  the  out-patient  staff. 

University  College  is  at  the  bottom  of 
Gower  Street  in  a  new  building,  erected  by 
the  late  Sir  Blundell  Maple.  The  Medical 
School  is  likewise  a  new  building,  provided 
by  Sir  Donald  Currie.  It  offers  excellent 
accommodation  for  all  the  needs  of  under- 
graduate study  and  advanced  research. 

Westminster  is  situated  in  Broad  Sanctu- 
ary, opposite  Westminster  Abbey.  The  Hos- 
pital contains  upwards  of  200  beds. 

London  School  of  Medicine  for  Women  is 
in  the  Gray's  Inn  Road  in  connection  with  the 
Royal  Free  Hospital.  The  entire  school  has 
in  late  years  been  rebuilt  and  greatly  enlarged. 
The  laboratories  are  roomy,  well  lighted, 
and  fully  equipped.  The  Hospital  has  165 
beds,  all  of  which  are  available  for  clinical 
instruction. 

St.  Mary's  is  situated  in  Praed  Street;  the 
total  number  of  beds  is  341.  During  the  past 
year,  as  a  result  of  the  increasing  scope  of  the 
Department  for  Therapeutic  Inoculation  un- 
der Sir  Almroth  Wright,  F.R.S.,  a  block  of 
consulting-rooms,  waiting-rooms,  and  labora- 
tories has  been  equipped  in  the  new  wing  of 
the  Hospital,  and  is  now  in  use. 

I  will  take  back  a  bit  of  what  I  said  about 

186 


LONDON" 

never  having  been  to  any  of  these  hospitals. 
I  did  go  out  to  St.  Mary's  to  see  the  great 
glass-blowing  establishment  of  Sir  A.  E. 
Wright.  The  works  are  in  operation  from 
some  time  after  midday  till  the  small  hours 
of  the  morning.  The  only  reason  I  know  for 
this  schedule  is  that  the  good,  husky  men 
who  come  here  from  all  over  the  world,  are 
a  little  diffident  about  doing  this  glass-blow- 
ing stunt  at  a  time  a  visitor  might  be  expected 
to  call.  There  happened  to  be  one  man 
there,  however,  when  I  dropped  in  a  little 
after  twelve  o'clock  one  day.  But  he  apolo- 
gized for  being  at  work  so  early.  He  said  he 
had  only  been  at  the  laboratories  for  a  few 
days,  and,  therefore,  it  shouldn't  be  held  up 
against  him.  He  showed  me  a  fine  collec- 
tion of  glassware  that  he  had  constructed, 
and  said  he  hoped  to  have  a  packing-case  full 
to  take  back  to  America  with  him.  He  also 
said  that  he  dreamed  every  night  of  the  way 
his  local  medical  society  would  open  its  eyes 
when  he  got  up  and  showed  all  that  glass- 
ware. 

"But  the  opsonic  index,"  I  said;  "are  you 
having  any  difficulty  in  learning  the  technic  .^" 

"Not  the  least  in  the  world,"  he  replied; 
"don't  you  see  how  much  glassware  I've 
made  already.^" 

187 


MEDICAL  EUROPE 

I  wasn't  quite  satisfied  that  the  gentleman 
had  fully  grasped  the  true  scientific  spirit  of 
laboratory  work,  and  so  I  sought  further 
information.  After  wandering  about  the  de- 
serted rooms  for  some  time,  I  finally  came 
upon  a  diener,  who  said  if  I  liked  he  would 
show  me  the  technic  of  determining  the 
opsonic  index  while  I  was  waiting,  as  it  was 
really  a  simple  matter.  He  had  easily  picked 
it  up  while  helping  about  the  laboratory.  I 
thanked  him  and  sat  down  as  he  started 
in  to  work.  First  he  took  several  pieces  of 
glass  tubing  and  cut  them  into  convenient 
lengths.  Then  he  started  in  to  make  pipettes. 
After  he  had  used  up  all  the  glass  he  had,  he 
hunted  up  some  more  and  continued  to  blow 
pipettes.  Suddenly  he  stopped,  looked  at  his 
watch  and  said,  "Will  you  excuse  me  while 
I  go  and  get  my  tea  ?  It's  a  bit  after  my  hour; 
I'll  finish  when  I  come  back."  I  told  him  by 
all  means  not  to  miss  his  tea,  and  as  I  had 
come  several  thousand  miles  to  beard  the  index 
in  its  lair,  I  waited.  At  the  end  of  an  hour  or 
so,  a  bare-armed,  rosy-faced,  intelligent  look- 
ing scrubwoman  came  along.  She  was  a 
good-hearted  soul,  and  as  she  said  it  might 
be  late  in  the  afternoon  before  the  doctors 
got  there,  she  would  show  me  all  about  the 
work  herself.     She  had  done  quite  a  bit  of  it 

188 


LONDOX 


in  odd  hours.  So  she  wiped  off  her  hands, 
picked  up  a  length  of  glass  tubing,  and 
started  in  to  make  a  pipette.  Then  she  blew 
a  second  and  started  in  on  a  third.  I  made 
my  escape,  ran  down  the  stairs,  out  on  to  the 
street,  and  passing  the  euphonious  "Load  of 
Hay"  hotel  I  found  my  way  back  to  the  City, 
where  I  at  once  ordered  a  long  and  cooling 
drink  with  special  instruc- 
tions to  the  waiter  not  to 
put  a  straw  in  it,  for  I  had 
no  desire  to  be  reminded 
of  glass  tubes. 

Really  I  have  no  right 
to  scribble  so  frivolously 
regarding  so  remarkable  a 
work  as  that  developed  by 
Wright  and  his  associates 
in  the  last  few  years.  But 
a  man  like  Sir  Almroth, 
who  can  do  things  that  will  set  the  whole 
medical  world  on  edge,  and  establish  a  vac- 
cine therapy  that  promises  to  have  a  perma- 
nent place  in  our  modern  scientific  thera- 
peusis,  won't  be  disturbed,  I  am  sure,  by  a 
little  good-natured  raillery.  And  besides, 
they  do  use  up  a  good  many  miles  of  glass 
tubing  out  at  new  St.  Mary's. 


XVI. 

LIVERPOOL THE    SUNDAY    EXODUS THE 

GREAT    UNIVERSITY COOPERATIVE 

METHODS. 

There  were  several  hundred  passengers 
on  the  boat  that  landed  me  in  Liverpool  one 
Saturday  at  about  eight  o'clock  in  the  even- 
ing, and  not  one  of  them,  so  far  as  I  could 
ascertain,  except  myself  stayed  over  night 
there.  The  others,  who  were  wiser  than  I, 
hustled  to  the  railway  station  and  caught  the 
first  train  out  for  Chester,  Wales,  London,  or 
some  other  place  fit  to  spend  a  Sunday  in. 

I  dined  alone  that  evening,  and  the  next 
morning  breakfasted  alone.  So  far  as  I  could 
see  I  was  the  only  guest  at  the  big  Adelphi 
Hotel.  I  asked  the  clerk  what  the  necessity 
was  for  hotels  in  Liverpool,  anyway,  and  he 
told  me  that  boats  occasionally  sailed  so  early 
in  the  morning  that  people  were  compelled  to 
get  to  town  the  night  before.  Otherwise  he 
quite  agreed  with  me  that  hotels  could  easily 
be  wiped  off  the  Liverpool  map. 

Imagine  a  city  the  size  of  Liverpool,  with 
over  a  million  people,  the  second  largest  city 
in  the  British  Empire,  so  deserted  that  I  (and 

190 


T.IVERrOOL 

a  friend  who  came  to  my  rescue  and  bore  me 
off  to  Chester  for  the  day)  walked  from  its 
heart  at  midday  for  over  a  mile  to  the  Biken- 
head  Ferry  without  meeting  a  dozen  people. 

But  on  week  days  Liverpool  is  a  busy 
town,  and  I  saw  here  one  of  the  finest  medical 
institutions  in  all  Europe. 

The  Liverpool  School  of  Medicine  was 
established  in  1834,  although  before  then 
clinical  instruction  was  given  at  the  Royal 
Infirmary.  On  the  foundation  of  University 
College,  Liverpool,  the  Royal  Infirmary  of 
Medicine  was  incorporated  with  it.  That 
became  a  part  of  the  Victoria  University  in 
1884,  and  in  1903  the  present  University 
was  established  in  place  of  the  latter. 

The  four  names  most  prominent  on  the 
medical  faculty  of  the  University  are:  W.  A. 
Herdman,  Professor  of  Zoology;  C.  S.  Sher- 
rington, Professor  of  Physiology  and  Histol- 
ogy; Sir  Rupert  Boyce,  Professor  of  Pathol- 
ogy, and  Ronald  Ross,  Professor  of  Tropical 
Medicine.  Of  these  men  probably  Ross,  he 
of  the  mosquito  fame,  is  best  known  to 
Americans,  although  Sherrington,  on  account 
of  his  brilliant  work  in  neuropathology,  runs 
a  close  second.  Herdman  and  Boyce,  how- 
ever, are  names  to  conjure  with  here  in  Liver- 
pool, for  they  have  done  many  worthy  things. 

191 


MEDICAL  EUROPE 

The  buildings  and  laboratories  of  the 
medical  school  are  extensive  and  up  to  date. 
I  doubt  if  there  are  any  better  in  Europe. 
The  Chemical  Department;  the  Hartley  Bo- 
tanical Laboratories;  the  Zoological  Depart- 
ment; the  George  Holt  Physics  Laboratory; 
the  New  Medical  School  Building  of  five 
floors;  The  Thompson- Yates  Laboratories, 
(a  large  block  of  buildings  in  itself),  and  the 
Johnson  Laboratories,  devoted  wholly  to  post- 
graduate teaching  and  research,  all  form  a 
group  of  structures  of  which  Liverpool  is 
justly  proud. 

I  spent  most  of  my  time  here  wandering 
about  the  research  laboratories.  Benjamin 
Moore,  the  dean  of  the  school  and  Professor 
of  Bio-Chemistry,  is  a  charming  man  to  meet. 
I  know  an  American  who  dropped  in  there 
one  day  and  asked  Moore  if  there  was  a 
chance  for  him  to  work.  The  next  day  he 
was  working  on  a  problem  in  bio-chemistry. 
In  Germany  it  would  have  been  the  next 
week  or  the  next  month. 

Sherrington's  laboratory  is  interesting  espe- 
cially for  the  black-board  method  he  has  of 
teaching  histology.  There  is  a  black-board 
at  each  microscope,  and  under  each  micro- 
scope is  fixed  a  certain  part  of  the  section  he 
wishes  to  show.     Then  Sherrington  goes  from 

192 


LIVERPOOL 

microscope  to  microscope  making  drawings  of 
the  particular  thing  at  each.  For  instance,  if 
he  is  teaching  the  structure  of  the  kidney, 
one  microscope  will  show  glomerulus  only, 
the  next  convoluted  tubule,  the  next  straight 
tubule,  and  so  on.  As  soon  as  a  student  has 
seen  and  drawn  one  part  he  goes  on  to  the 
next. 

In  the  Cancer  Research  Laboratory  we 
were  shown  by  Dr.  Walker  the  long-tube 
microscope  and  the  mono-chromatic  light 
which  they  use  exclusively.  The  combina- 
tion gives  a  picture  that  is  truly  remarkable, 
and  cell  structure  is  revealed  that  it  is  abso- 
lutely impossible  to  see  under  ordinary  con- 
ditions. The  work  of  Moore  and  Walker 
along  cytological  lines  in  relation  to  malig- 
nant growths  is  too  well  known  to  need  dis- 
cussion here. 

Liverpool  offers  a  remarkably  attractive 
array  of  clinical  material,  and  this  is  admir- 
ably presented  to  the  student  at  the  Royal 
Infirmary  and  the  United  Hospitals  Clinical 
School,  which  comprises  eight  hospitals  with 
a  total  of  840  beds. 

The  Royal  Infirmary  was  founded  in  the 
middle  of  the  eighteenth  century,  and  first 
erected  on  the  site  now  occupied  by  St. 
George's  Hall,  and  was  opened  in  1749.     In 

13  193 


MEDICAL  EUROPE 

1821  the  institution  was  removed  to  its  pres- 
ent situation,  where  a  large  building,  fronted 
by  a  heavy  stone  colonnade  in  classical  style, 
was  erected,  and  with  additions  and  alter- 
ations remained  in  use  until  1887,  when  it 
was  pulled  down  to  make  room  for  the  present 
building,  which  was  opened  in  1890.  No  care 
was  spared  to  make  the  present  Infirmary  as 
perfect  as  the  science  of  hospital  construction 
at  the  time  made  possible,  and  various  im- 
provements have  since  been  introduced,  so 
that  the  building  still  remains  a  model  of  its 
kind,  and  is  looked  upon  as  such  by  authori- 
ties on  hospital  construction  all  over  the  world. 

The  wards  are  arranged  in  separate  clinics, 
with  a  physician  or  surgeon,  and  a  resident 
medical  or  surgical  officer  attached  to  each; 
each  clinic  having  a  clinical  room  in  which  to 
interview  patients,  and  conduct  microscopical 
and  chemical  tests. 

The  United  Hospitals  Clinical  School, 
Liverpool,  consists  of  the  following  institu- 
tions associated  for  purposes  of  clinical  in- 
struction; The  Royal  Southern  Hospital;  The 
David  Lewis  Northern  Hospital;  The  Stanley 
Hospital;  The  Eye  and  Ear  Infirmary;  The 
Hospital  for  Women;  The  Infirmary  for 
Children;  St.  Paul's  Eye  and  Ear  Hospital; 
St.   George's  Hospital  for  Skin  Diseases. 

194 


LIVERPOOL 

The  object  of  the  scheme  of  cooperation 
which  these  hospitals  have  adopted  is  that  of 
utiHzing,  to  the  greatest  advantage,  the  large 
amount  of  clinical  material  which  they  contain. 
The  regulations  which  govern  this  cooperation 
have  received  the  approval  of  the  University. 

One  of  the  most  interesting  features  of  the 
University  is  the  Liverpool  School  of  Tropical 
Medicine,  which  is  governed  by  a  committee 
from  the  University  of  Liverpool,  the  Royal 
Southern  Hospital,  and  the  Merchants  and 
Shipowners  of  Liverpool.  The  aim  of  the 
school  is  not  only  to  train  men  on  the  special 
subject  of  tropical  diseases,  but  to  promote 
research  along  these  lines. 

That  great  progress  has  been  made  in  the 
latter  aim  can  be  seen  from  a  recent  report  of 
Sir  Rupert  Boyce  upon  the  treatment  of  Sleep- 
ing Sickness  and  other  forms  of  trypanoso- 
myasis  by  arsenic  and  mercury.  These  dis- 
coveries, as  pointed  out  by  Boyce,  may  save 
millions  of  lives  and  make  vast  tracts  of  terri- 
tory now  useless,  on  account  of  trypanosome- 
bearing  pests,  inhabitable  and  capable  of 
cultivation.  Investigation  is  carried  on  under 
Ronald  Ross,  who  is  head  of  the  department, 
both  at  Runcorn,  a  few^  miles  out  of  Liver- 
pool, and  also  in  the  Johnson  Tropical  Lab- 
oratory at  the  University. 

195 


MEDICAL  EUROPE 

This  work  in  Tropical  Medicine  attracts 
men  to  Liverpool  from  all  parts  of  the  world; 
especially  from  the  tropics.  There  is  one 
American  working  here  on  a  fellowship  which 
supports  him,  and  he  is  turning  out  some 
high-grade   work. 

The  John  W.  Garrett  International  Fellow- 
ship in  Pathology  and  Physiology  of  one  hun- 
dred pounds  ($500),  awarded  annually  and 
tenable  for  one  year,  is  open  to  members  of 
universities  and  medical  schools  in  the  United 
States. 

It  was  my  good  fortune  while  in  Liverpool 
to  live  in  commons  or,  as  it  is  more  stylishly 
printed  in  the  catalogue,  "Hall  of  Residence." 
I  say  good  fortune,  not  on  account  of  the  food, 
or  the  tiny  attic  room  lighted  by  a  single 
feeble  gas-jet,  that  I  occupied,  but  rather  on 
account  of  the  experience.  I  have  eaten  in 
Italian,  French,  German,  and  various  other 
foreign  pensions,  but  I  have  never  been  so 
out  of  my  natural  element  as  I  was  here. 

The  proper  costume  for  breakfast  was  bath- 
robe and  slippers.  The  maid  did  not  appear 
at  this  meal,  but  we  took  our  plates  to  the 
buffet  and  helped  ourselves  to  porridge, 
bloaters,  and  'am  and  eggs,  which  were  set 
out  in  abundance;  and  filled  our  cups  with 
tea,  or  with  that  mysterious  mixture  of  luke- 

196 


LIVERPOOL 

warm  dishwater  and  burned  vegetable  of  un- 
known source  which  the  great  British  nation 
jolly  themselves  into  believing  is  coffee.  Dur- 
ing breakfast  hour  the  maid  is  busy  polishing 
our  shoes,  and  we  select  them  from  the  long 
row  in  the  hall  (provided  some  one  else  hasn't 
already  done  so)  and  go  back  to  our  room  to 


smoke  a  pipe  and  think  about  dressing  some 
time  before  lunch.  There  are  no  early  hours 
here  as  in  Germany.  If  any  one  appeared  in 
a  laboratory  before  ten  o'clock  the  University 
would  expel  him. 

Dinner  is  rendered  even  more  dismal  than 
breakfast,  owing  to  the  fact  that  one  has  to 
descend  to  the  sitting-room  to  wait  the  dinner 

197 


MEDICAL  EUROPE 

call  and  return  to  the  sitting-room  after  dinner 
for  coffee  (I  again  use  the  English  terminology) . 

If  an  English  boarding-house  sitting-room 
wouldn't  drive  one  into  the  last  stages  of 
homesickness  the  conversation  that  is  carried 
on  in  one  would.  And  when  the  deadly  drug 
above  referred  to  is  finally  passed  around,  you 
take  a  cup,  for  you  have  reached  the  stage 
when  you  don't  care  what  becomes  of  you. 

I  thought  the  whole  thing  was  as  bad  as  it 
could  be  the  first  evening  I  put  in  there.  But 
the  second  evening  my  American  friend,  who 
was  responsible  for  my  being  there,  told  a 
funny  story  and  the  gloom  that  settled  over 
that  assembly  in  consequence  was  to  the  gloom 
of  the  previous  evening  as  is  the  blackness 
of  a  London  fog  to  the  auriferous  halo  of  a 
virgin  saint. 

This  friend  of  mine,  by  the  way,  never 
could  be  serious.  One  of  the  fellows  was 
telling  at  breakfast  about  pawning  a  watch 
and  chain.  The  chain  had  a  gold  guinea  on 
it,  and  the  chap  explained  that  ''the  blooming 
pawnbroker,  don't-you-know, "  had  ''pared" 
the  gold  piece  so  that  it  was  a  great  deal 
smaller  than  when  he  "  put  it  up."  "Perhaps 
it  wasn't  really  smaller,"  my  friend  said 
quietly,  "but  perhaps  money  looked  bigger 
to  you   when  you   pawned  your  watch. " 

198 


LIVERPOOL 

"Oh,  no,"  the  Enghshman  replied.  ''They 
really  do  that  sort  of  thing."  And  a  very 
serious  volley  of  confirmatory  affirmations 
went  around  the  room.  In  trying  to  keep  a 
straight  face  I  choked  on  a  bloater  and  had 
to  leave  the  table. 

Really  it  isn't  fair  to  talk  this  way  about 
English  lack  of  humor,  for  that  evening  I 
went  to  a  Music  Hall  and  heard  much  better 
jokes  than  we  get  in  vaudeville  at  home. 
And  all  of  them  set  the  house  in  an  uproar. 
An  especially  popular  one  seemed  to  be  a 
remark  of  Harry  Lauder's.  "Do  you  know," 
he  said,  "my  poor  uncle  lost  all  of  his  luggage 
coming  from  Manchester  down  'ere."  'Ow 
did  it  'appen.^  ^^'y?  the  cork  came  out  of 
his  whiskey  flask!"  The  house  was  doubled 
up  with  laughter  before  I  got  the  full  effect  of 
the  joke  myself.  I  remarked  to  my  friend 
on  the  quickness  with  which  they  caught  it. 
"Well,  they  ought  to  get  it  fairly  quickly," 
he  replied.  "Lauder  has  been  springing  that 
joke  to  the  same  audiences  for  fifteen  years." 

Liverpool  is  a  great  place  in  which  to  buy 
books.  There  was  a  second-hand  book-store 
here  that  I  rambled  into  one  morning  and 
didn't  leave  until  late  in  the  afternoon.  Not 
content  with  exhibiting  the  thousands  of 
volumes  in  the  main  shop,  the  old  bookseller 

199 


MEDICAL  EUROPE 

took  me  to  his  store-house  and  it  was  there, 
with  a  pocket  full  of  candles,  I  spent  my  day 
amid  countless  piles  of  old  volumes  gathered 
from  the  ends  of  the  earth.  And  my  day  was 
by  no  means  wasted,  for  when  I  emerged  from 
this  old  loft,  covered  with  cobwebs  and  dust 
and  candle  grease,  I  bore  in  my  arms  a  load 
of  volumes  that  I  had  long  been  searching  for 
and  which  the  old  bookseller  parted  with  for 
a  very  modest  sum. 

As  a  matter  of  fact  I  believe  the  good- 
hearted  old  chap  rather  pitied  me  when  I 
asked  him  if  he  had  charged  me  enough,  for 
he  said:  "This  is  all  clear  gain  to  me,  sir. 
I've  been  in  this  business  for  a  good  many 
years  and  you  are  the  first  man  who  ever 
came  here  looking  for  old  Pathologies.  I 
have  to  take  the  things  in,  in  the  way  of  lots, 
but  I  never  sold  any  of  them  before."  Alas^ 
for  my  honored  specialty!  I  felt  depressed, 
despite  my  unearthed  treasures. 

Buying  books,  by  the  way,  is  the  least 
bothersome  thing  one  can  do  abroad,  they 
are  so  quickly  disposed  of.  When  I  buy  a 
book  I  have  it  done  up  securely,  write  my 
name  and  home  address  on  it,  stamp  it,  and 
deposit  it  in  the  nearest  post-office.  That's 
all  there  is  to  it,  and  when  I  get  back  home  the 
books  are  there  waiting  for  me.    All  old  books 

200 


LIVERPOOL 

in  Englisli,  and  all  books  not  in  English,  go  in 
duty  free,  so  there  are  no  customs  to  bother  one. 
It's  an  awful  temptation  to  include  in  this 
cliapter  a  little  pilgrimage  that  a  small  but 
select  party  of  good  Americans,  whose  in- 
terests are  medical,  made  down  into  Wales. 
How  they  stayed  at  one  of  the  cleanest  and 
coziest  of  Welsh  inns  ever,  whose  name,  '*The 
x\ngel,"  was  not  the  least  of  its  delights.  How 
they  went  to  an  old  parish  church  and  saw 
the  culmination  of  an  episode  that  began  in 
a  Berlin  pension  which  happened  to  house 
at  the  same  time  a  youthful  American  medical 
man  and  a  young  and  charming  Welsh  lady. 
But  all  of  this  is  a  secret.  And  far  be  it 
from  the  writer  to  betray  confidences. 

Liverpool  is  not  only  ''  journey's  beginning" 
but  sad  to  say  it  may  be  likewise  *' journey's 
end."  I  do  not  wish  to  write  a  final  chapter 
for  this  book,  for  books  of  travel  should  have 
no  final  chapter.  No  more,  I  maintain,  than 
should  books  of  love  or  of  science.  Just  as 
no  life  is  wholly  complete,  so  no  story  of  real 
life  ought  to  be  ended.  Leave  me,  if  you  will 
then,  on  a  boat  that  has  sailed  for  home, 
looking  backward  for  a  glimpse  of  a  land 
that  is  not  by  any  means  being  left  forever 
behind. 


APPENDIX  I. 

BERLIN  MEDICAL  COURSES  FOR  AMERICANS. 

The  Year  Book  Committee  of  tlie  Anglo- 
American  Medical  iVssociation  of  Berlin  has 
compiled  a  list  of  the  courses  *  most  frequently 
taken  by  British  and  American  physicians 
studying  in  Berlin,  which  is  given  here  in  full. 

Most  of  these  courses  begin  on  the  first 
day  or  during  the  first  week  of  each  month 
and  last  for  four  weeks.  Unless  otherwise 
indicated  the  fee  quoted  is  per  man.  Asterisks 
indicate  the  Instructors  who  speak  English. 
A.   University  Courses. 

Regular  student  courses  at  the  University 
of  Berlin  are  designed  more  for  student  than 
for  postgraduate  work.     iVn  occasional  visit 


*  Complete  lists  of  the  Berlin  Medical  Courses  are  to  be 
found  in  the  following  publications: 

1.  Das  medizinische  Berlin.     Price  mks.   1. 

2.  Schacht,    Ratgeber    und    Wegweiser    f.    Teilnehmer    an 
arztlichen  Fortbildungsken.     Price  mks.  1. 

3.  Verzeichnis  der  Vorlesungen  (List  of  University  Courses). 
Price,  pfg.  60. 

4.  Verzeichnis  der  Monatskurse,  gratis 

5.  Kurse  fur  praktische  Aerzte,  gratis. 

6.  Verein  fur  Aerztekurse,  gratis. 

7.  Ferien-Kurse  fiir  praktische  Aerzte,  gratis  at  Rothacker's 
book-store,  Friedrichstr.  10.5.  B. 

205 


MEDICAL  EUROPE 

to  these  courses  is  welcomed  without  formal- 
ity. To  attend  regularly  one  must  matricu- 
late. 

The  University  work  is  divided  into  a 
Winter  and  a  Summer  Semester,  the  Winter 
Semester  lasting  from  October  15th  to  March 
15th   and  the   Summer  Semester  from  April 


University  of  Berlin 


15th  to  August  15th.  The  time  for  matricu- 
lation is  comprised  in  the  two  weeks  preced- 
ing the  opening  of  the  Semester,  and  the  first 
two  weeks  of  the  Semester.  The  matricula- 
tion fee  is  18  marks.  Diploma  and  passport 
must  be  shown. 
B.   Vacation  Courses  (Ferien-Kurse). 

Are  given  twice   a  year    (March   and   Oc- 
tober) during  the  University  Holidays.    These 

206 


COURSES  FOR  AMERICANS 

courses  are  for  graduates  in  medicine  and  can 
be    very    higWy   recommended,    so   they   are 
usually  overcrowded. 
C.  Voluntary  Assistant  ships. 

May  occasionally  be  obtained  at  some  of 
the  clinics.  Application  must  be  made  in 
person. 

COURSES. 

Internal  Medicine, 

Prof.  Dr.  Michaelis,  PoHklinik,  Karltsr.  18  I; 
4  weeks;  daily,  12-1.  Monthly  from 
March  to  October.  Practical  course  in 
Diagnosis  and  Therapy  of  Internal  Dis- 
eases.    Fee,  mks.  40. 

Prof.  Dr.  Brandenburg,  Poliklinik,  Karlstr. 
18a;  4  weeks;  3  hours  weekly.  Physical 
Diagnosis.     Fee,  mks.  40. 

Prof.  Dr.  Strauss,  Poliklinik,  Karlstr.  58;  4 
weeks.  Mon.,  Wed.,  Fri.,  9.30-10.30. 
Given  any  month  upon  agreement.  1, 
Stomach  and  Intestinal  Diseases;  2,  Dis- 
eases of  Metabolism;  3,  Internal  Medica- 
tion; 4,  Rectoscopy  and  examination  of 
f^ces.  Fee,  mks.  50  per  course.  Special 
course:  Diseases  of  Liver  and  Kidneys, 
Monday  and  Friday,  5-Q  p.m.  Fee,  mks. 
40. 

Dr.    F.    Klemper,    Poliklinik,    Luisenstr.    19; 

207 


MEDICAL  EUROPE 

4  weeks;  daily,  12-2.  Monthly.  Especial 
attention  to  Diseases  of  the  Heart  and 
Lungs.     Fee,  mks.  75. 

Dr.  O.  Jacobson,  Jewish  Hospital,  Auguststr. 
14/16;  4  weeks;  daily,  1-2.30.  Given  in 
April,  May  and  June.  Bedside  and  Clini- 
cal Observation.     Fee,  mks.  75. 

Dr.  Mosse,  first  assistant  to  Prof.  Senator. 
Institute  of  Prof.  Senator;  4  weeks;  daily; 
hours  by  arrangement.  Bedside  work. 
Oberartz  Dr.  Steyer,  assistant  to  Prof. 
Krause.  H.  Medical  Clinic  Charite.  Time, 
character  of  course  and  fee  by  arrange- 
ment. 

Prof.  Lazarus,  Charite,  "Leyden  Wards." 
Time,  character  of  course,  and  fee  by  ar- 
rangement. 

Stomach  and  Intestines. 
Dr.    Gllicksmann,    Luisenstr.    15;    4    weeks; 

4  days  weekly,   10.30-12.      Every   month. 

Diseases    of   the   Stomach,    Intestines    and 

Liver.    Diagnosis  and  Therapy.    Fee,  mks. 

50. 
Drs.  Eisner  and  Ury,  Elsasserstr.  39;  4  weeks; 

daily    11-1.      Monthly.      Diseases    of    the 

Stomach  and  Intestines.     Fee,  mks.  60. 
*Dr.    Cohnheim,   Karlstr.    20a;    4   weeks;    3 

times  weekly,  10-12.     Monthly.     Diagnosis 

208 


COURSES  FOR  AMERICANS 

and  Treatment  of  Diseases  of  the  Stomach 
and  Intestines.  Fee,  mks.  50. 
Privatdozent  Dr.  Albu,  Ziegelstr.  26;  4 
weeks;  4  times  weekly,  12-1,  by  arrange- 
ment. Monthly.  Diagnosis  and  Treatment, 
Diseases  of  the  Stomach  and  Intestines. 
Fee,  mks.  50. 

Surgery. 

Dr.  W.  Bail,  Augusta-Hospital.  Operative 
Surgery,  Abdominal  and  Brain.  On  the 
cadaver.  Fee,  mks.  75,  for  each  man  in 
class  of  4-6  men;  mks.  100  for  each  man 
in  class  of  2-3  men. 

Oberarzt  Dr.  Braun,  Krankenhaus  Fried- 
richshain ;  4  weeks ;  2  hours  3  times  weekly. 
Monthly  except  August.  Operative  Sur- 
gery. Special  Abdominal  Surgery.  On 
the  cadaver.  Fee,  mks.  75,  mks.  5  for 
attendant. 

Prof.  Dr.  Borchardt,  Virchow-Krankenhaus. 
Surgical  Diagnosis  and  Therapy.  By  ar- 
rangement. 

Dr.  Zondels,  Poliklinik,  Miinzstr.  16;  4  weeks; 
3  times  weekly;  12.30-2.00  p.m.  Surgical 
Diagnosis  and  Therapy.     Fee,  mks.  60. 

Dr.  Helbing,  Hoffa's  Klinik.  Am  Circus  9. 
Orthopedic  Surgery,  with  practical  exer- 
cises on  the  patient.    Roentgen  ray  demon- 

14  209 


MEDICAL  EUROPE 

strations.  Fee  and  time  according  to 
arrangement. 

Dr.  Wolff,  Chausseestr.  3;  4  weeks;  2-3 
times  weekly;  7.00-9.00  p.m.  Surgical 
operations  upon  animals  and  upon  phan- 
tom.    Fee,  mks.  60-80. 

Prof.  Dr.  Schmieden,  Prof.  Bier's  Klinik;  2 
weeks;  daily  except  Sunday.  By  arrange- 
ment; number  in  course  4-6.  Fee,  mks.  50. 
One  week,  six  days  beginning  Monday,  5  to 
6  men.     Hypersemia.     Fee,  mks.  25. 

Dr.  Eugen  Joseph,  Prof.  Bier's  Klinik,  1 
week;  six  days  beginning  every  Monday. 
Hypersemia.     To  5-6  men.     Fee,  mks.  25. 

GyncBcology. 

Prof.  Dr.  Nagel,  Luisenstr.  14;  4  weeks; 
days  and  hours  by  arrangement.  Monthly. 
Gynaecological  Diagnosis  and  Therapy,  for 
Practitioners.     Fee,   mks.    60. 

Dr.  T.  H.  Landau,  Philippstr.  21;  4  weeks; 
3  times  weekly.  Monthly  when  sufficient 
number  of  men  to  take  the  course.  Gynae- 
cological Diagnosis  and  Treatment.  Oper- 
ations before  the  class.     Fee,  mks.  100. 

Dr.  Runge,  in  Prof.  Bumm's  Klinik, 
Charite;  4  weeks;  5  times  weekly,  11.00- 
1.00.  Monthly.  Gynaecological  Diagnosis 
and  Treatment.     Fee,  mks.   100. 

210 


COURSES  FOR  AMERICAXS 

Dr.  Blumreicli,  Luisenstr.  13;  4  weeks;  3 
days  weekly,  1.30-3.00  p.m.  Monthly. 
Course  in  practical  Gynaecology  upon  the 
living  subject  and  phantom.     Fee,  mks.  40. 

Dr.  Rumpel,  Kgl.  Klinik,  Charite,  Ziegelstr. 
5a;  4  weeks;  twice  weekly,  6.00-8.00  p.m. 
Time  given  indefinite.  Course  in  Gynae- 
cology.    Fee,  mks.  60. 

Obstetrics. 

Dr.  Martin,  Charite-Krankenhaus;  4  weeks; 
daily.  In  March  and  September.  Practical 
Obstetrics.  Number  of  men  in  course,  5. 
Fee,   mks.   300. 

Dr.  Bosslar,  Charite-Krankenhaus;  4  weeks; 
daily.  In  October  and  April.  Practical 
Obstetrics.  Number  of  men  in  course,  5. 
Fee,  mks.  300. 

Skin  and  Venereal. 

*Dr.  Max  Joseph,  Poliklinik,  Ziegelstr.  26; 
4  weeks;  daily,  9.00-11.00  a.m.  Monthly. 
Diagnosis  and  Treatment  of  Diseases  of 
the  Skin.     Fee,  mks.  40. 

Dr.  Saalfeld,  Poliklinik,  Kronprinzen-Ufer  5; 
4  weeks;  3  times  weekly.  Monthly.  Prac- 
tical course  in  Dermatology.  Practical 
course  in  Cosmetics.  Fee,  mks.  75  per 
course. 

211 


MEDICAL  EUROPE 

*Dr.  Ernest  Frank,  Karlstr.  38;  4  weeks; 
2-3  times  weekly.    Monthly.    Fee,  mks.  50. 

Dr.  Blaschko,  Neue  Jacobstr.  1-3;  4  weeks; 
3  times  weekly.  Monthly.  Skin  and  Vene- 
real Diseases.  Fee,  mks.  40.  Microscopical 
work  in  laboratory  for  the  semester. 
Daily,  8.00  A.M.-4.00  p.m.     Fee,  mks.  100. 

*Dr.  J.  Cohn,  Friedrichstr.  225;  4  weeks;  5 
times  weekly.  Monthly.  Skin  and  Vene- 
real Diseases.     Fee,  mks.  100. 

Dr.  Arthur  Lewin,  Oranienburgerstr.  45;  4 
weeks;  5  times  weekly.  Monthly.  Vene- 
real Diseases  including  Cystoscopy.  Fee, 
mks.    100. 

Dr.  Ledermann,  Friedrichstr.  131-a;  4  weeks; 
twice  weekly,  10.00-11.00  a.m.  Monthly. 
Venereal  Diseases.     Fee,  mks.  30. 

Nose,  Throat  and  Ear. 

*Dr.  Max  Halle,  Elsasserstr.  122;  4  weeks; 
daily  except  Sunday,  12.00-2.00  p.m.  Dis- 
eases of  the  Nose  and  Throat.  Fee,  mks. 
75;    with  operations,  mks.  100. 

*Dr.  Meyer,  with  Prof.  Dr.  Heymann,  Poli- 
klinik,  Luisenstr.  17;  4  weeks;  3  times 
weekly.  In  April,  May,  and  June.  Practi- 
cal course  in  Laryngoscopy  and  Rhinoscopy. 
Fee,  mks.  60.  Histology  of  the  Accessory 
Sinuses.  Arranged  at  anytime.  Fee,  mks.  50. 

212 


COURSES  FOR  AMERICANS 

Dr.  Max  Sclieler,  Poliklinik,  Joliannisstr. 
14/15;  4  weeks;  4  times  weekly.  At  any 
time  by  arrangement.  Laryngology  and 
Rhinology  with  practical  work  and  minor 
operations.      Fee,    mks.    60. 

*Dr.  G.  Ritter,  Luisenstr.  11.  By  arrange- 
ment. Operative  course  on  tlie  Ear.  At 
least  3  men  in  course.     Fee,  mks.  60. 

*Dr.  H.  J.  AYolff,  Poliklinik,  Reinickendorfer- 
strasse  7;  4  weeks;  3  times  weekly,  6.00- 
8.00  P.M.  Monthly.  Operative  course  on 
the  Ear.     Fee,  mks.  60. 

*Prof.  Dr.  Jansen,  Karlstr.  17;  4  weeks;  3 
times  weekly.  Diseases  of  the  Ear.  Fee, 
mks.  50.  Information  concerning  opera- 
tions by  Prof.  Dr.  Jansen  can  be  obtained 
at  his  clinic. 

Eye. 

'j'Prof.  Dr.  Gutmann,  Schiffbauerdamm  20. 
^Privatdozent   Dr.    Helbron,    University   Eye 

Klinik,   Ziegelstrasse  5. 
*Dr.  Oppenheimer,  Saarbriickerstr.   17. 
*Dr.  Pollak,  Karlstr.  18.    Klinik  of  Prof.  Dr. 

Silex.     For  details  consult  the  Instructors. 

Neurology. 

"^Prof.  Dr.  Ziehen,  with  Prof.  Koppen,  Poli- 
klinik f.  Xervenkrankheiten,  Charite-Kran- 

213 


MEDICAL  EUROPE 

kenhaus.  Course  in  research  work  to 
experienced  neurologists.  For  details  see 
Prof.  Ziehen  at  the  Nervenklinik,  Charite, 
12.00   M.    daily. 

Prof.  Dr.  Oppenheim,  Poliklinik,  Karlstr. 
27  I;  4  weeks;  3  times  weekly.  In 
November,  December,  April  and  May. 
Course  in  Nervous  Diseases  with  demon- 
strations on  patients.     Fee,  mks.  40. 

*Dr.  Cassirer,  Klinik  of  Prof.  Oppenheim. 
Time  by  arrangement.  Course  in  Nervous 
Diseases  with  demonstration  on  patients. 
Maximum  number  in  course,  4.  Fee,  mks. 
40. 

*Dr.  Flatau,  Klinik  of  Prof.  Oppenheim;  4 
weeks;  3  times  weekly.  Psychotherapy 
and  Hypnotism.  Fee,  mks.  40.  By  ar- 
rangement. Electro-diagnosis  and  Electro- 
therapeutics. Number  of  men  in  course, 
2.     Fee,  mks.  50. 

Dr.  Toby  Cohn,  Poliklinik,  Karlstr.  18a. 
Time  by  arrangement.  Electro-diagnosis 
and  Electro-therapeutics.  Fee,  mks.  50. 
Diagnosis  of  Nervous  Diseases.  Fee,  mks. 
50.  Dr.  Cohn  holds  his  Polyclinic  from 
12.00-2.00  P.M.   daily. 

*Dr.  Jacobsohn,  Luisenstr.  19.  Daily  for  one 
month.  By  arrangement.  Histological, 
topographical  anatomy  of  the  cerebro-spinal 

214 


COURSES  FOR  A^NIERICAXS 

system.  Fee,  mks.  200  for  1  man,  mks.  150 
each  for  2  men,  mks.  100  each  for  3  men. 
Maximum  number  of  men  in  course,  3. 

*Dr.  Jacobsohn,  Luisenstr.  19.  By  arrange- 
ment. Pathological  Histology  of  the  Nerv- 
ous System.     Fee,  mks.  50. 

*I)r.  Ivcwandowsky,  Physiological  Institute, 
Dorotheenstr.   35.      Bv    announcement. 


FuiKiiiin  K  Wn.iiELM  Hospital — ]'i;i:i,(X 


Physiological  Pathology  of  the  Nervous 
System  with  demonstrations  on  animals. 
Must  be  four  in  course.     Fee,  mks.  100. 

Pediatrics. 

Prof.   Heubner,  Kinderklinik  der  Universitat 

(Charite-Krankenhaus) . 
Prof.  A.  Baginsky,  Reinickendorferstr.  32. 
Dr.  Leo  Langstein,  Kinderklinik  der  Konig- 

lichen   Charite. 

215 


MEDICAL  EUROPE 

Dr.  Ludwig  Meyer,  Kurassierstr.  21,  22. 
Sanitatsrat  Dr.  Cassel,  Elsasserstr.  27. 

Cystoscopy. 

*Dr.  Casper,  Friedrichstr.  125.     Every  month 

by  arrangement.   2-3  men  in  class.     Fee,- 

mks.    100. 
*Dr.  Frank,  Poliklinik,  Karlstr.  38.    For  four 

weeks.     Twice  weekly.     Each  month.    2-4 

men  in  class.    Fee,  mks.  100. 
*Dr.  Thumin,  Prof.  Landau's  Hospital,  Phil- 

ippstr.  21.     Every  month  by  arrangement. 

Fee,  mks.  75. 
*Dr.  Jacobi,  Poliklinik,  Konigstr.  51.     Every 

month  by  arrangement.     Fee,  mks.  60-100. 
*Dr.   Karo,  Koniggratzerstr.   43.      10  lessons 

by  arrangement.     2-3  men  in  class.     Fee, 

mks.  100. 

Pathology, 

Dr.  Oestreich,  Privatdozent,  Augusta-Hos- 
pital; 4  weeks;  3  times  weekly.  Monthly 
except  August.  Macroscopic  Diagnosis  of 
diseases  of  the  organs.  Fee,  mks.  40. 
Pathological  histological  diagnosis.  Fee, 
mks.  50.  Diagnosis  of  diseases  of  the 
Stomach  and  Intestines.  Fee,  mks.  40. 
Pathological  Technic.     Fee,  mks.   60. 

Dr.    Westenhoeffer,    Privatdozent.    Kranken- 

210 


COURSES  FOR  AMERICAXS 

haiis  Moabit;  4  weeks;  dally,  10.00  a.m. 
till  2.00  P.M.  Every  month.  Gross  Pathol- 
ogy and  Autopsy  Technic.     Fee,  mks.  50. 

*Dr.  Pick,  Privatdozent,  Krankenhaus 
Friedrichshain ;  4  weeks;  3  times  weekly. 
Monthly  except  August.  General  and  spe- 
cial Pathology.  Fee,  mks.  75.  x4t  Landau's 
Hospital,  Philippstrasse  21,  general  and 
special  Pathology.     Fee,  mks.  75. 

Prof.  Dr.  Dietrich,  Stadtkrankenhaus 
Charlottenburg.  Courses  in  pathological 
Histology.      Sections   and   Demonstrations. 

Bacteriology. 

Prof.  Dr.  Ficker,  Hygienisches  Institut;  4 
weeks;  daily,  9.30-2.00.  In  November, 
February,  May  and  July.  Demonstrations 
of  the  making  of  culture  media.  Bacterio- 
logical examination  of  milk  and  water. 
Cultivation,  staining  and  examination  of 
various  forms  of  bacteria.  Serum  diagnosis. 
Infection  of  small  animals.  Testing  of 
new  culture  media,  stains,  and  methods  of 
serum  diagnosis.  Haniiolysin,  Prsecipitin 
and  Opsonin  work.  Fee,  mks.  Q5,  mks.  5 
for  attendant. 

Prof.  Dr.  Wassermann,  Institut  fiir  Infek- 
tions-krankeiten.  Daily  for  three  months. 
Once  a  year  beginning  in  October.    Making 

217 


MEDICAL  EUROPE 

of  culture  media.  Cultivation,  staining  and 
examination  of  various  forms  of  bacteria. 
Serum  diagnosis.  Infection  of  animals. 
Experimental  bacteriology.  Fee,  mks.  65 
per  month. 

*Dr.  Klopstock,  Institut  fur  medizinische 
Diagnostik,  Schiffbauerdamm  6/7;  4  weeks; 
2-3  times  weekly.  Every  month  but  August. 
Clinical  Microscopy  with  especial  attention 
to  the  examination  of  urine,  faeces,  etc. 
Fee,  mks.  60. 

Practical  instruction  in  the  Theories  of 
Immunity  may  be  obtained  at  the  Hy- 
gienisches  Institut  or  the  Institut  fiir  Infek- 
tions-krankheiten.  Upon  application  to  the 
secretary  of  either  of  the  above  Institutes 
all  information  will  be   supphed. 

Men  wishing  to  do  research  work  can 
usually  obtain  working  places  in  the  differ- 
ent laboratories  upon  personal  application. 
Fee  varies. 

A  knowledge  of  German  is  absolutely  neces- 
sary if  one  wishes  to  do  bacteriological  work. 

Blood. 

Prof.  Dr.  Grawitz,  Stadtkrankenhaus  Char- 
lottenburg.    Clinical  pathology  of  the  blood. 

Dr.  Hans  Winterfeld,  Krankenhaus  Moabit. 
Practical  work  in  methods  of  blood  exami- 

218 


COURSES  FOR  AJNIERICAXS 

nation  with  opportunity  to  acquire  tecli- 
nic  on  patients. 

Prof.  Dr.  Plelin,  Charite.  Pathology  of  the 
blood,  with  demonstrations  and  practical 
exercises. 

Dr.  von  Bergmann,  Oberarzt,  II.  Med. 
Klinik  der  Charite.  Practical  course  in 
clinical  H^ematology.  As  these  courses  are 
given  irregularly,  it  is  necessary  to  apply 
to   the   Instructors   for   further  details. 

Anatomy,  Histology,  Embryology. 

Royal  Anatomical  Institute.  Matriculation 
and  information  at  the  University. 

Dr.  Hein  or  Dr.  Prohse,  Royal  Anatomical 
Institute,  Luisenstr.  oQ.  1,  Topographical 
Anatomy.  2,  Descriptive  Anatomy. 
Demonstrations  upon  previously  dissected 
cadavers.  Those  desiring  this  work  must 
apply  to  either  Dr.  Hein  or  Dr.  Prohse. 
Not  more  than  3  in  course.  Fee,  mks.  200  for 
one  man,  mks.  200  for  course  for  2  men,  mks. 
250  for  course  for  3  men,  for  each  course. 

Dr.  F.  Kopsch,  Royal  Anatomical  Institute, 
gives  the  following  courses,  by  arrange- 
ment: 1,  General  Histology;  2,  Special 
Histology.  Student  is  given  80-90  speci- 
mens in  each  course.  Fee,  mks.  200  for 
one  man,  mks.  100  each  for  2  men,  for  each 

219 


MEDICAL  EUROPE 

course.  3,  Microscopical  teclmic  in  all 
its  forms.  Every  day  for  eight  weeks  under 
direct  supervision  of  tlie  Instructor.  Fee, 
mks.  200  for  each  man,  mks.  100  each  for 
2  men.  1,  General  Embryology;  2,  Special 
Embryology.  By  arrangement.  Fee,  mks. 
200.  Price  according  to  work.  General 
Anatomy  of  the  Brain  and  Spinal  Cord. 
Stained  specimens  of  cross  sections  of  the 
cord  and  medulla  oblongata.  Study  of  the 
general  relationship  of  the  tracts  and  cell 
groups  in  the  Cerebro-spinal  System.  By 
arrangement.  Fee,  mks.  100  for  one  man, 
mks.  150  for  two  men,  mks.  300  for  three 
men;    more  than  3  men  not  taken. 

Dietetic  Cooking. 

Fraul.  Elise  Hanneman,  Lette-Verein,  Vic- 
toria-Luisenstr.  6;  4  weeks;  twice  weekly. 
By  arrangement.  Class  limited  to  10.  Fee, 
mks.  30. 

Hospitals  and  Laboratories, 

Charite,  Charitestrasse. 
Konigliche  Klinik,  Ziegelstr.  5-9. 
Krankenhaus      am     Friedrichshain,     Lands- 

berger- Alice   159,   Friedrichshain   2. 
Augusta-Hospital,  Scharnhorststr.  11. 
Krankenhaus  am  Urban. 

220 


COURSES  FOR  AMERICANS 

Krankenhaus  Moabit,  Tiirmstr.  21. 
Stadtkrankcnliaus    Cliarlottenburg,    Kirchstr. 

20. 
Kaiser    unci    Kaiserin    Friedricli-Kinderkran- 

kenhaus,  Relnlckendorferstr.  32. 
Krankenhaus  der  jiidisclien    Gemelnde,  Au- 

guststrasse  14/16. 
Rudolph    Yirchow-Krankenhaus,    Augusten- 

burger  Platz. 

Laboratories. 
Konlgl.    x4natomisches    Institut    und    Biolog- 

isches   Institut,   Luisenstr.   oQ. 
Physiologisches  Institut,   Dorotheenstr.   32. 
Hygienisches  Institut,  Hessischestr.  4. 
Institut  fiir  Infections-krankheiten.    Nordufer, 

Fohrerstr. 

General  Inform  ation . 

Passports. — It  is  imperative  that  citizens 
of  the  United  States  of  America  bring  with 
them  passports  from  the  State  Department  at 
Washington,  as  passports  are  no  longer  issued 
by  i^mbassadors  or  Consuls.  They  must  also 
register  at  their  Consulate  in  compliance  with 
a  recent  Act  of  Congress  the  details  of  which 
will  be  explained  at  the  Consulate. 

Police  Regulations. — Registration  of  for- 
eigners will  be  explained  by  housekeeper  upon 
request  and  should  be  promptly  complied  with. 

221 


APPENDIX  II. 

GERMAN    UNIVERSITIES. 

A  COMPLETE  account  of  the  German  Uni- 
versity, its  nature,  function,  organization,  and 
historical  development,  is  given  by  Paulsen  in 
his  book,  "The  German  Universities,"  and 
I  quote  freely  from  Thilly  and  Elwang's 
translation  of  that  work,  by  kind  permis- 
sion of  Charles  Scribner's  Sons,  certain 
points  that  may  be  of  interest. 

The  German  universities  are  state  institu- 
tions and  the  university  teachers,  with  the 
title  of  professors,  are  salaried  officials  of  the 
state.  x\s  state  institutions  they  are  founded, 
supported  and  administered  by  the  Govern- 
ment. From  it  they  receive  their  organiza- 
tion and  laws.  The  regulations  governing 
the  universities  and  the  faculties  are  passed 
by  the  Government,  usually  with  the  advice 
of  the  corporations.  In  Prussia  the  faculty 
statutes  are  prescribed  by  the  Ministry  of 
Education. 

But  the  universities  are  not  only  state 
institutions,  they  are  also  independent  cor- 
porations of  scholars.  The  head  of  the  uni- 
versity, the  rector,  is  always  chosen  annually 

222 


GERMAN  UNIVERSITIES 

by  the  full  body  of  professors,  and  is  one  of 
their  number.  He  represents  the  university 
in  its  external  affairs;  the  university  officials 
are  subject  to  his  orders;  he  has  charge  of  the 
immatriculation  of  students;  and  he  controls 
the  societies  and  the  meetings  of  the  student 
body.  The  German  rector  is  the  visible 
symbol  of  the  corporative  independence  of  the 
university. 

The  different  faculties  also  possess  impor- 
tant functions  as  self-governing  bodies.  The 
full  corps  of  professors,  who  are  the  faculty's 
administrative  body,  annually  elect  one  of 
their  number  as  dean,  to  act  as  their  pre- 
siding officer. 

The  instructor  in  a  university  enjoys  an 
independence  in  the  form  and  content  of  his 
duties  that  is  not  equalled  by  that  of  any 
other  government  office.  Upon  his  appoint- 
ment a  professor  receives  a  wholly  general 
commission  to  teach  certain  branches,  and  he 
is  allowed  to  interpret  this  commission  for 
himself;  he  decides  for  himself  what  lectures 
and  exercises  are  to  be  offered,  the  number  of 
hours  to  be  devoted  to  every  subject,  the  topics 
to  be  treated,  and  the  methods  to  be  followed. 
He  is  merely  bound  to  deliver  at  least  one 
private  and  one  public  course  of  lectures  dur- 
ing   each    semester.      There    are    no    official 

223 


MEDICAL  EUROPE 

courses  of  study  as  in  the  schools.  There  is 
no  supervising  of  the  efficiency  of  the  instruc- 
tion; no  revision  by  supervising  officials,  and 
no  statements  of  account,  except  by  the 
laboratories. 

The  teaching  corps  of  a  German  university 
comprises  two  kinds  of  teachers,  whose  legal 
status  is  thoroughly  distinct:  1,  professors, 
who  are  appointed  and  paid  by  the  state; 
2,  private  docents,  or  independent  instructors, 
upon  whom  the  faculties  have  bestowed  the 
privilege  of  teaching,  but  who  have  no 
official  duties  and  receive  no  salaries. 

A  distinction  is  also  made  between  pro- 
fessors: the  ordinary  (prdentliche)  or  full 
professors  constitute  the  administrative  body, 
while  the  extraordinary  (ausserordentliche) 
professors  take  no  part  in  the  administrative 
affairs  of  the  university  or  faculty. 

A  professor's  official  stipend  comes  from 
two  different  sources :  he  draws  a  salary  from 
the  state  and  also  receives  compensation  from 
attendants  upon  his  private  lectures.  The 
most  recent  regulation  in  Prussia,  dating 
from  1897,  fixes  the  initial  salary  of  an  ordi- 
nary professor  at  4000  marks  (Berlin  4800), 
of  an  extraordinary  professor  at  2000  (Berlin 
2400).  These  figures  are  increased  five  (at 
Berlin  six)  times,  at  intervals  of  four  years,  by 

224 


GERMAN  UNIVERSITIES 

the  addition  of  400  marks  each  time.  There 
is,  in  adcHtion,  an  extra  allowance  for  domicile 
of  540-900  marks.  The  Income  from  the 
honorarium  or  fee  varies  exceedingly,  depend- 
ing u})on  the  subject  taught,  the  attendance, 
and  the  number  of  lectures,  as  well  as  the 
personal  drawing-power  of  the  teacher;  it 
fluctuates  ])etween  a  few  hundred  and  many 
thousand    marks.      The   large    incomes   from 


I     4 


HI 


J  u  1 1  A  N  N  S'l' A  HI'    T  N  V I  k:\I  A  I!  V — 7 )  K  r.S  I  >  KN 


the  honorarium  are  found  especially  in  the 
large  law  and  medical  faculties. 

In  addition  to  their  salary  and  honorarium 
they  get  decorations. 

Originally  confined  to  political  and  military 
circles,  the  decorations,  titles,  and  patents 
of  nobility  began  to  invade  the  academic 
world  in  the  eighteenth  century,  and  have 
multiplied  to  such  an  alarming  extent  during 
the  nineteenth  that  they  are  almost  in  danger 
of   losing   their   distinction.      The   II  of  rat   is 


225 


MEDICAL  EUROPE 

Indigenous  to  the  modern  court-university.  The 
Geheimrat  did  not  become  common  until  the 
last  generation,  his  appearance  being  connected 
with  the  development  of  the  laboratory  system. 

The  private  docent  is  a  scholar  to  whom 
the  faculty  has  extended  the  privilege  of 
teaching,  but  who  is  not  a  member  of  the 
official  teaching  body,  and  is  under  no  official 
obligation  to  teach.  He  has  the  use  of  the 
university  buildings  and  laboratories;  his 
lectures  and  exercises  are  announced  in  the 
catalogue,  and  are,  in  case  the  student  is 
formally  enrolled  in  the  course,  accepted  as 
regular  work.  As  a  general  thing  the  private 
docent  of  to-day  looks  forward  to  a  professor- 
ship ;  for  the  individual  the  position  of  private 
docent  is  a  stepping-stone  to  a  salaried  profes- 
sorship, and  for  the  universities  it  is  a  training- 
school  for  professors. 

According  to  the  German  view  the  univer- 
sity professor  has  a  double  function  to  per- 
form: he  is  both  a  scholar  or  a  scientific 
investigator  and  a  teacher  of  knowledge. 

The  teacher  must  have  learning,  he  must 
possess  extensive  scientific  knowledge  and 
understand  the  methods  employed  in  his  field, 
and  he  must  have  an  original  mind,  the  power 
to  see  things  from  an  independent  point  of 
view,  and  to  handle  them  in  an  original  way. 

22G 


GERMAN  UNIVERSITIES 

The  complete  possession  of  tliese  two  quali- 
ties characterizes  the  ideal  university  teacher. 

Academic  circles  are  at  present  governed 
in  their  estimate  of  a  man  primarily  by  his 
scientific  productivity;  his  ability  to  teach 
is  a  secondary  consideration,  or  rather,  it  is 
looked  upon  as  an  accident  of  the  former 
quality.  The  university  has  a  tendency  to 
regard  itself  primarily  as  a  scientific  institu- 
tion; the  function  of  teaching  is  not  apt  to 
be  emphasized. 

The  university  student  selects  his  field  of 
study,  his  university,  his  teachers,  and  the 
lectures  to  be  taken.  And  he  also  assumes  an 
independent  mental  attitude  towards  what  the 
teacher  offers  him.  He  can,  if  he  chooses, 
stay  away  from  the  lectures  altogether;  no 
one  is  going  to  call  him  to  account  for  that; 
no  one  is  going  to  ask  him  wdiy  he  is  doing  it 
or  how  he  is  spending  his  time,  at  least  no 
one  is  officially  charged  to  do  such  a  thing. 

But  a  high  relation  to  the  truth  is  demanded 
of  the  student:  when  he  enters  the  university 
he  theoretically  places  himself  in  the  service 
of  the  truth.  To  seek  for  it  and  appropriate  it 
is  the  first  duty,  to  apply  it  and  make  it  fruit- 
ful if  he  can,  the  further  task  of  every  one 
who  considers  himself  worthy  to  be  counted 
among  the  elect  of  the  nation. 

227 


T^IEDICAL  EUROPE 

Gerviaji  Universities  Other  than  Berlin. 

Wiirzburg,  in  Bavaria,  is  a  mediuni-sized 
university  town.  Among  the  men  on  its 
medical  faculty  are  Stohr,  anatomist,  Yon 
Leube  in  medicine,  Hofmeier  in  gynaecology, 
and   Shoenborn   in   surgery. 

Tubingen,  in  Wlirtemberg,  in  the  Black 
Forest,  has  a  university  which  was  founded 
in  1477.  Baumgarten  in  pathology,  Doeder- 
lein  in  obstetrics,  Romberg  and  Vierordt  in 
clinical  medicine,  are  among  the  men  to  be 
found  here. 

Strasburg,  in  Alsace-Lorraine,  is  a  consider- 
able city,  whose  university,  which  was  the 
only  complete  one  in  France  except  that  at 
Paris,  was  founded  in  1621.  It  was  abolished 
by  the  French  during  the  great  revolution, 
but  was  restored  by  the  Germans  in  1872. 
Chiari,  who  made  Prague  so  popular  a  centre 
for  American  pathologists  for  so  many  years, 
is  now  here;  he  having  taken  the  place  left 
vacant  by  Von  Reckingshausen.  Then  there 
is  Schmiederberg,  Fiirstner  and  Hofmeister, 
all  well  known.  Krehl  and  Xaunyn  are  also 
good  men  to  work  with  in  medicine. 

Munich,  in  Bavaria,  is  considered  by  many 
people  the  most  charming  city  in  Europe. 
Its  university  absorbed  that  of  Landshut  in 
1826.     It  is  a  centre  of  German  fine  arts  and 

228 


GERMAN  UNIVERSITIP:S 

here  are  found  hundreds  of  Americans  who 
devote  themselves  to  things  other  than  cHnics. 
I  confess  that  the  Boeckhn  paintings  I  found 
here  interested  me  more  than  even  Miiller's 
hving  pictures.  Miiller  is  one  of  the  first 
chnicians  of  Europe,  however,  and  most 
internists  get  around  to  Munich  in  the  course 
of  their  travels,  to  see  him  conduct  his  famous 
clinic.      Then   there   is   Krapelin    here,    also. 


The  University— Munich 


who  all  the  neurologists  have  to  see  to  make 
their  European  trip  complete.  Gruber,  whose 
name  is  linked  with  Widal's  in  the  Gruber- 
Widal  reaction;  Voit,  the  physiologist;  Riick- 
ert,  the  anatomist;  Bollinger  and  Diirck, 
pathologists;  Winckel,  the  gynecologist,  and 
Everbush,  the  ophthalmologist,  are  important 
members  of  the  medical  faculty. 

Rostock,  in  Mecklenburg-Schwerin,  has  an 
ancient  university,  founded  in  1419.     This  is 

229 


MEDICAL  EUROPE 

a  semi-mediseval  town,  but  little  frequented  by 
Americans  for  medical  work.  One  can  get 
very  good  rooms  in  this  town  for  five  dollars 
a  month,  and  dinners  for  an  equal  sum.  The 
average  cost  of  living  for  a  student  is  about 
fifteen  dollars  a  month. 

Marburg,  in  Nassau,  is  beautifully  situated. 
It  is  a  small  city,  and  its  University  was 
founded  in  1527.  The  great  Von  Behring's 
name  is  enrolled  on  this  faculty. 

The  University  of  Leipzig,  in  Saxony,  is 
made  use  of  by  a  few  Americans  for  medical 
study.  Leipzig  is  one  of  the  mo^t  interesting 
of  German  cities,  and  one  finds  there  many 
Americans  in  various  lines  of  work  outside  of 
medicine.  On  the  medical  faculty,  however, 
are  many  worthy  men,  among  whom  may  be 
mentioned  Curschmann,  Trendelenburg,  and 
March  and. 

Konigsberg,  in  Prussia,  founded  in  1544, 
has  a  number  of  good  men  on  its  faculty.  A 
student's  club,  the  Palaestra  x^lbertina,  made 
possible  by  the  gift  of  Dr.  Fritz  Lange,  of 
New  York,  is  along  the  same  lines  as  the 
Harvard  Union,  and  is  open  to  the  entire 
student  body. 

Breslau,  the  most  populous  city  in  Prussia 
after  Berlin,  is  situated  at  the  junction  of  the 
Ohlau    and   the   Oder.      The   university   was 

230 


GERMAN  UNIVERSITIES 

founded  in  1702,  and  Its  medical  scliool  is  in 
a  flourisliing  condition.  Here  are  to  be  found 
a  number  of  famous  men:  Ponfick,  in  pathol- 
ogy; riuegge,  in  bacteriology;  Striimpell,  in 
medicine;  Ivuestner,  in  gynaecology;  Garre, 
in  surgery;  Huerthle,  in  physiologic  chemistry; 
Czerny,    in   pediatrics. 

Greifswald,  in  Prussia,  was  founded  in  1456. 
LoefBer  and  Grawitz  are  the  two  names  best 
known  to  us  on  this  medical  faculty. 

Halle,  in  Prussian  Saxony,  on  the  Saale, 
was  united  with  Wittenberg  in  1817.  This 
very  pretty  town,  not  far  from  Leipzig,  is  well 
worth  a  visit.  Harnack's  laboratory  is  of 
interest  to  all  physiologic  chemists,  and  Er- 
berth,  whose  name  is  associated  with  the 
typhoid  bacillus,  is  here.  Frankel  also  should 
not  be  passed  by  without  mention. 

Giessen,  in  Hesse  Darmstadt,  founded  in 
1607,  is  situated  in  a  plain  some  thirty  miles 
from  Frankfort  am  Main.  Bostroem  in 
pathology,  Strahl  in  anatomy,  and  Pfannen- 
stiel  in  obstetrics,  are  well-known  professors 
in  this  university. 

Gottingen,  in  Hanover,  was  founded  in 
1734.  Here  are  quite  a  number  of  well- 
known  men;  for  example,  Ebstein  in  medi- 
cine, Braun  in  surgery,  Cramer  in  neurology, 
and   Borst    (tlie   author   of  the   big   book   on 

233 


3IEDICAL  EUROPE 

tumors)  in  pathology.  Ehrlicli  lectures  here 
for  three  weeks  each  year  on  the  most  recent 
progress   in   immunity   research. 

The  different  faculties  award  prizes  each 
year  for  special  work.  The  problem  for  1906 
was,  "The  state  of  alkalinity  of  the  blood,  and 
red  and  white  corpuscles  in  nervous  and 
mental  diseases."  The  faculty  naively  state 
that  the  problem  is  not  literary,  but  is  to  be 
solved  by  investigation  of  the  patients. 

Heidelberg,  in  Baden,  founded  in  1386, 
is  known  by  name  to  everyone.  So  are  Arnold, 
Czerny,  Fuerbringer,  Erb,  Knauff,  Roshtorn, 
Kossel,  Gottlieb,  and  Nissl,  to  say  nothing  of 
a  number  of  lesser  lights,  for  Heidelberg  does 
not  have  its  great  reputation  for  name  alone. 
You  will  surely  go  there,  if  only  to  say  you 
have  been;  and  if  you  decide  to  stay  it  will 
be  well  worth  your  while.  It's  a  great  temp- 
tation to  w^rite  a  chapter  about  Heidelberg 
alone,  but  then  Mark  Twain  has  written  of 
it  so  perfectly  in  his  "Tramp  Abroad"  that 
anything  after  that  would  fall  flat. 

Freiburg,  in  Baden,  was  founded  in  1456, 
and  is  beautifully  located  near  the  Black 
Forest.  The  university  was  best  known,  per- 
haps, because  of  the  great  pathologist  Ziegler, 
who  was  here  for  so  many  years  before  his 
death.     He  has  been  succeeded  by  Schmorl. 

234 


GERMAN   UNIVERSITIES 

In  eye  diseases  here  is  Axenfeld;  in  gyna3col- 
ogy  and  obstetrics,  Kronig,  and  in  surgery, 
Kraske.  Wcismann,  tlie  famous  zoologist,  is 
also  here. 

Jena,  in  Saxe  Weimar,  a  small  town,  whose 
university  was  founded  in  1558,  is  famous 
not  so  much  for  its  general  faculties,  jjerhaps, 
as  it  is  for  single  individuals.  First  of  all  there 
is  Ernst  Ilaeckel,  the  great  zoologist,  who  has 
done  so  much,  among  other  things,  to  inter- 
pret Darwinism  and  spread  the  theory  of  pro- 
gressive development.  Ilaeckel's  "Natural 
Ilistoiy  of  Creation"  has  been  translated  into 
tw^elve  languages  and  has  reached  its  fourth 
English  edition. 

Then  there  are  the  great  Jena  glass  and 
lens  factories  here.  It  is  to  Abbe,  who  filled 
the  chair  of  applied  mathematics,  natural 
philosopliy  and  astronomy  in  the  University 
of  Jena,  tliat  we  owe  the  modern  microscope. 
lie  interested  himself  in  the  then  modest  lens 
work  of  Carl  Zeiss,  laying  down  exact  mathe- 
matical formula}  for  the  grinding  of  lenses 
and  attempting  to  establish  exact  chemical 
formula)  for  glass-making  to  do  away  with 
inequalities  in  the  product.  By  the  aid  of  the 
Prussian  Government  this  goal  was  finally 
reached,  and  now  Germany  leads  the  world 
in  the  manufacture  of  fine  optical  instruments. 

235 


MEDICAL  EUROPE 

Eriangen,  in  Bavaria,  is  ten  miles  from 
Nuremberg.  The  university  was  founded 
in  1743.  The  medical  faculty  here  is  com- 
paratively small  and  the  men  composing  it 
less  well  known  than  in  many  of  the  other 
universities. 

Bonn  is  of  great  antiquity,  though  the 
present  university  dates  only  from  1818.  It  is 
situated  in  Rhenish  Prussia  on  the  left  bank 
of  the  Rhine,  some  fifteen  miles  from  Cologne. 

It  was  from  here  that  Bier  was  called  to 
Berlin  to  take  Von  Bergman's  clinic.  Such 
well-known  men  as  Pjfliiger  in  physiology, 
Ribbert  in  pathology,  Finkler  in  hygiene, 
Fritsch  in  obstetrics,  and  Nussbaum  and 
Schiefferdecker,  who  have  added  much  to 
our  knowledge  of  the  central  nervous  system, 
are  at  Bonn. 


W^e^    oV\A.A,vt^^a/c»t^ 


:  -."i  \-^^n^!±-^4Pati, 


